Idea Bank.

ERIC Educational Resources Information Center

Science Teacher, 1986

1986-01-01

Provides descriptions of activities and programs that have been successful with secondary science students. Includes ideas related to repairing radio-controlled cars, cooperative science-library center, observation exercises, recordkeeping skills and peer grading, DC power supply, chemistry of poison ivy, spore science, and a tic-tac-toe review…

The Math Explorer: Games and Activities for Middle School Youth Groups.

ERIC Educational Resources Information Center

Murphy, Pat; Lambertson, Lori; Tesler, Pearl

This book offers games and mathematics activities using a hands-on approach for middle school students and features games, puzzles, experiments, and projects. Contents include: (1) "Boxed In!"; (2) "Oddball"; (3) "Pig"; (4) "Madagascar Solitaire"; (5) "Fantastic Four"; (6) "Eratosthenes' Sieve"; (7) "Hopping Hundred"; (8) "Tic-Tac-Toe Times"; (9)…

Sharing Teaching Ideas.

ERIC Educational Resources Information Center

Crouse, Richard J.; And Others

1991-01-01

The first idea concerns a board game similar to tic-tac-toe in which the strategy involves the knowledge of the factorization of quadratic polynomials. The second game uses the calculation of the surface areas of solid figures applying the specific examples of cigar boxes and cylindrical tin cans. (JJK)

Synonym Success--Thanks to the Thesaurus

ERIC Educational Resources Information Center

Mountain, Lee

2007-01-01

After a class of ninth graders discovered the helpfulness of the thesaurus in such synonym activities as Synonym Tic-Tac-Toe and Cross-Synonym Puzzles, they started using the thesaurus to locate "the exactly right word" while drafting compositions. They also enriched their oral vocabularies during these activities by discussing synonyms from the…

Play It Again, Sam! Adapting Common Games into Multimedia Models Used for Student Reviews.

ERIC Educational Resources Information Center

Metcalf, Karen K.; Barlow, Amy; Hudson, Lisa; Jones, Elizabeth; Lyons, Dennis; Piersall, James; Munfus, Laureen

1998-01-01

Provides guidelines on how to adapt common games such as checkers, tic tac toe, obstacle courses, and memory joggers into interactive games in multimedia courseware. Emphasizes creating generic games that can be recycled and used for multiple topics to save development time and keep costs low. Discusses topic themes, game structure, and…

Open to Suggestion.

ERIC Educational Resources Information Center

Journal of Reading, 1987

1987-01-01

Offers (1) suggestions for improving college students' study skills; (2) a system for keeping track of parent, teacher, and community contacts; (3) suggestions for motivating students using tic tac toe; (4) suggestions for using etymology to improve word retention; (5) a word search grid; and (6) suggestions for using postcards in remedial reading…

Fun and Games, but Learning Too.

ERIC Educational Resources Information Center

Ahmad, Paula

1989-01-01

Recommends the use of visual art games to introduce art units and stimulate student interest. Outlines strategies for 10 visual art games adaptable for most age and skill levels. Based on familiar games such as "tic-tac-toe" or "hangman," these activities deal with artists, artistic skills or concepts, and art history. (LS)

Odaminodaa Ojibwemong!! = Let's Play in Ojibwe!!

ERIC Educational Resources Information Center

White, James L.

The booklet contains directions for designing six word games to provide motivation, reinforcement, and review for students of all ages, from children to adults, as they learn the Ojibwe language. Step-by-step instructions are provided for making and playing Quiz Board, Tic-Tac-Toe, Concentration, Lottery, Lingo (Bingo), and Incocomp. Suggestions…

[Psychometric attributes of the Spanish version of A-TAC screening scale for autism spectrum disorders].

PubMed

Cubo, E; Sáez Velasco, S; Delgado Benito, V; Ausín Villaverde, V; García Soto, X R; Trejo Gabriel Y Galán, J M; Martín Santidrián, A; Macarrón, J V; Cordero Guevara, J; Benito-León, J; Louis, E D

2011-07-01

As there are no biological markers for Autism Spectrum Disorders (ASD), screening must focus on behaviour and the presence of a markedly abnormal development or a deficiency in verbal and non-verbal social interaction and communication. To evaluate the psychometric attributes of a Spanish version of the autism domain of the Autism-Tics, AD/HD and other Comorbidities Inventory (A-TAC) scale for ASD screening. A total of 140 subjects (43% male, 57% female) aged 6-16, with ASD (n=15), Mental Retardation (n=40), Psychiatric Illness (n=22), Tics (n=12) and controls (n=51), were included for ASD screening. The predictive validity, acceptability, scale assumptions, internal consistency, and precision were analysed. The internal consistency was high (α=0.93), and the standard error was adequate (1.13 [95% CI, -1.08 a 3.34]). The mean scores of the Autism module were higher in patients diagnosed with ASD and mental disability compared to the rest of the patients (P<.001). The area under the curve was 0.96 for the ASD group. The autism domain of the A-TAC scale seems to be a reliable, valid and precise tool for ASD screening in the Spanish school population. Copyright © 2010 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

21 CFR 888.3730 - Toe joint phalangeal (hemi-toe) polymer prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Toe joint phalangeal (hemi-toe) polymer prosthesis. 888.3730 Section 888.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-toe) polymer prosthesis. (a) Identification. A toe joint phalangeal (hemi-toe) polymer prosthesis...

21 CFR 888.3730 - Toe joint phalangeal (hemi-toe) polymer prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Toe joint phalangeal (hemi-toe) polymer prosthesis. 888.3730 Section 888.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-toe) polymer prosthesis. (a) Identification. A toe joint phalangeal (hemi-toe) polymer prosthesis...

21 CFR 888.3730 - Toe joint phalangeal (hemi-toe) polymer prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Toe joint phalangeal (hemi-toe) polymer prosthesis. 888.3730 Section 888.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-toe) polymer prosthesis. (a) Identification. A toe joint phalangeal (hemi-toe) polymer prosthesis...

21 CFR 888.3730 - Toe joint phalangeal (hemi-toe) polymer prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Toe joint phalangeal (hemi-toe) polymer prosthesis. 888.3730 Section 888.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-toe) polymer prosthesis. (a) Identification. A toe joint phalangeal (hemi-toe) polymer prosthesis...

21 CFR 888.3730 - Toe joint phalangeal (hemi-toe) polymer prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Toe joint phalangeal (hemi-toe) polymer prosthesis. 888.3730 Section 888.3730 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... (hemi-toe) polymer prosthesis. (a) Identification. A toe joint phalangeal (hemi-toe) polymer prosthesis...

Broken Toe

MedlinePlus

... fracture is severe — particularly if it involves your big toe — you may need a cast or even surgery to ensure proper healing. Most broken toes heal well, usually within four to six weeks. Sometimes, a broken toe may become infected ...

Broken toe - self-care

MedlinePlus

Fractured toe - self-care; Broken bone - toe - self-care; Fracture - toe - self-care; Fracture phalanx - toe ... often treated without surgery and can be taken care of at home. Severe injuries include: Breaks that ...

Exploring the Possibilities of Using Tic-Tac-Toe to Think and Communicate about Mathematics

ERIC Educational Resources Information Center

Clarkson, Philip C.

2008-01-01

Doing mathematics, and thinking about how you are doing it at the same time, are not the easiest things to do. It is even more difficult if students are not aware that they should be attempting both processes at the same time. They are likely to concentrate on the immediate task of "doing" the mathematics, rather than trying to access the deeper…

Variable Phenotype in Murine Transverse Aortic Constriction (TAC)

PubMed Central

Mohammed, Selma F.; Storlie, Jimmy R.; Oehler, Elise A.; Bowen, Lorna A.; Korinek, Josef; Lam, Carolyn SP; Simari, Robert D.; Burnett, John C.; Redfield, Margaret M.

2012-01-01

Background In mice, transverse aortic constriction (TAC) is variably characterized as a model of pressure overload induced hypertrophy (LVH) or heart failure (HF). While commonly used, variability in the TAC model is poorly defined. The objectives of this study were to characterize the variability in the TAC model and to define a simple, non-invasive method of prospectively identifying mice with HF versus compensated LVH after TAC. Methods Eight week old, male C57BL/6J mice underwent TAC or SHAM and then echo at three weeks post-TAC. A group of SHAM and TAC mice were sacrificed after the three week echocardiogram, while the remainder underwent repeat echo and sacrifice at nine weeks post-TAC. The presence of TAC was assessed with 2 dimensional echo, anatomic aortic m-mode and color flow and pulsed-wave Doppler examination of the transverse aorta (TA) and by LV systolic pressure (LVP). Trans-TAC pressure gradient was assessed invasively in a subset. HF was defined as lung/body weight > upper limit in SHAM operated mice. Results As compared to SHAM, TAC mice had higher TA velocity, LVP and LV weight and lower ejection fraction (EF) at three or nine weeks post-TAC. Only a subset of TAC mice (28%) developed HF. As compared to compensated LVH, HF mice were characterized by similar TA velocity and higher percent TA stenosis, but lower LVP, higher LV weight, larger LV cavity, lower EF and stress-corrected midwall fiber shortening and more fibrosis. Both EF and LV mass measured by echo at three weeks post-TAC were predictive of the presence of HF at three or nine weeks post-TAC. Conclusions In wild type mice, TAC produces a variable cardiac phenotype. Marked abnormalities in LV mass and EF at echo three weeks post-TAC identify mice with HF at autopsy. These data are relevant to appropriate design and interpretation of murine studies. PMID:21764606

In-Toeing and Out-Toeing in Children

PubMed Central

Wiley, James J.

1987-01-01

In-toeing and out-toeing problems are generally physiologic variants that arise from in utero posturing, and that gradually correct spontaneously during the active growing years of the child. Few torsional deformities result in genuine problems. Most residual effects are cosmetic, compounded by the anguish of concerned relatives and friends. Rarely is operative correction warranted. If corrective surgery comes under consideration, it is usually deferred until the patient reaches the age of 10. PMID:21263851

TAC Variable Sweep Model

NASA Image and Video Library

1960-05-14

Project: Wing Sweep Range Series TAC Variable Sweep Model configure 8 A. Taken at 8 foot tunnels building 641. L60-3412 through 3416 Model of proposed military supersonic attack airplane shows wing sweep range. TAC Models taken at the 8 Foot Tunnel. Photograph published in Sixty Years of Aeronautical Research 1917-1977 By David A. Anderton. A NASA publication. Page 53.

Tics

MedlinePlus

... Staying Safe Videos for Educators Search English Español Tics KidsHealth / For Teens / Tics What's in this article? ... tic, such as a nose twitch. What's a Tic? A tic is an uncontrolled sudden, repetitive movement ...

Tactile Toe Agnosia and Percept of a "Missing Toe" in Healthy Humans.

PubMed

Cicmil, Nela; Meyer, Achim P; Stein, John F

2016-03-01

A disturbance of body representation is central to many neurological and psychiatric conditions, but the mechanisms by which body representations are constructed by the brain are not fully understood. We demonstrate a directional disturbance in tactile identification of the toes in healthy humans. Nineteen young adult participants underwent tactile stimulation of the digits with the eyes closed and verbally reported the identity of the stimulated digit. In the majority of individuals, responses to the second and third toes were significantly biased toward the laterally neighboring digit. The directional bias was greater for the nondominant foot and was affected by the identity of the immediately preceding stimulated toe. Unexpectedly, 9/19 participants reported the subjective experience of a "missing toe" or "missing space" during the protocol. These findings challenge current models of somatosensory localization, as they cannot be explained simply by a lack of distinct representations for toes compared with fingers, or by overt toe-finger correspondences. We present a novel theory of equal spatial representations of digit width combined with a "preceding neighbor" effect to explain the observed phenomena. The diagnostic implications for neurological disorders that involve "digit agnosia" are discussed. © The Author(s) 2015.

Idiopathic toe walking.

PubMed

Oetgen, Matthew E; Peden, Sean

2012-05-01

Toe walking is a bilateral gait abnormality in which a normal heel strike is absent and most weight bearing occurs through the forefoot. This abnormality may not be pathologic in patients aged <2 years, but it is a common reason for referral to an orthopaedic surgeon. Toe walking can be caused by several neurologic and developmental abnormalities and may be the first sign of a global developmental problem. Cases that lack a definitive etiology are categorized as idiopathic. A detailed history, with careful documentation of the developmental history, and a thorough physical examination are required in the child with a primary report of toe walking. Treatment is based on age and the severity of the abnormality. Management includes observation, stretching, casting, bracing, chemodenervation, and surgical lengthening of the gastrocnemius-soleus complex and/or Achilles tendon. An understanding of idiopathic toe walking as well as treatment options and their outcomes can help the physician individualize treatment to achieve optimal results.

Marshak Lectureship: The Turkish Accelerator Center, TAC

NASA Astrophysics Data System (ADS)

Yavas, Omer

2012-02-01

The Turkish Accelerator Center (TAC) project is comprised of five different electron and proton accelerator complexes, to be built over 15 years, with a phased approach. The Turkish Government funds the project. Currently there are 23 Universities in Turkey associated with the TAC project. The current funded project, which is to run until 2013 aims *To establish a superconducting linac based infra-red free electron laser and Bremsstrahlung Facility (TARLA) at the Golbasi Campus of Ankara University, *To establish the Institute of Accelerator Technologies in Ankara University, and *To complete the Technical Design Report of TAC. The proposed facilities are a 3^rd generation Synchrotron Radiation facility, SASE-FEL facility, a GeV scale Proton Accelerator facility and an electron-positron collider as a super charm factory. In this talk, an overview on the general status and road map of TAC project will be given. National and regional importance of TAC will be expressed and the structure of national and internatonal collaborations will be explained.

Hammertoe and Mallet Toe

MedlinePlus

... hammertoe and mallet toe may involve changing your footwear and wearing shoe inserts. If you have a ... linked to: Certain shoes. High-heeled shoes or footwear that's too tight in the toe box can ...

Transcranial Alternating Current Stimulation (tACS) Mechanisms and Protocols

PubMed Central

Tavakoli, Amir V.; Yun, Kyongsik

2017-01-01

Perception, cognition and consciousness can be modulated as a function of oscillating neural activity, while ongoing neuronal dynamics are influenced by synaptic activity and membrane potential. Consequently, transcranial alternating current stimulation (tACS) may be used for neurological intervention. The advantageous features of tACS include the biphasic and sinusoidal tACS currents, the ability to entrain large neuronal populations, and subtle control over somatic effects. Through neuromodulation of phasic, neural activity, tACS is a powerful tool to investigate the neural correlates of cognition. The rapid development in this area requires clarity about best practices. Here we briefly introduce tACS and review the most compelling findings in the literature to provide a starting point for using tACS. We suggest that tACS protocols be based on functional brain mechanisms and appropriate control experiments, including active sham and condition blinding. PMID:28928634

Toe Walking in Children

MedlinePlus

... walking sometimes can result from certain conditions, including cerebral palsy, muscular dystrophy and autism spectrum disorder. Symptoms Toe ... can prevent the heel from touching the ground. Cerebral palsy. Toe walking can be caused by a disorder ...

Patterns and Predictors of Tic Suppressibility in Youth With Tic Disorders

PubMed Central

Conelea, Christine A.; Wellen, Brianna; Woods, Douglas W.; Greene, Deanna J.; Black, Kevin J.; Specht, Matthew; Himle, Michael B.; Lee, Han-Joo; Capriotti, Matthew

2018-01-01

Tic suppression is the primary target of tic disorder treatment, but factors that influence voluntary tic inhibition are not well understood. Several studies using the Tic Suppression Task have demonstrated significant inter-individual variability in tic suppressibility but have individually been underpowered to address correlates of tic suppression. The present study explored patterns and clinical correlates of reward-enhanced tic suppression in youth with tic disorders using a large, pooled dataset. Individual-level data from nine studies using the Tic Suppression Task were pooled, yielding a sample of 99 youth with tic disorders. Analyses examined patterns of tic suppressibility and the relationship between tic suppressibility and demographic and clinical characteristics. A large majority of youth demonstrated a high degree of tic suppression, but heterogeneous patterns of tic suppressibility were also observed. Better tic suppressibility was related to older age and more frequent tics but unrelated to other clinical variables, including presence of psychiatric comorbidity, psychotropic medication status, tic and premonitory urge severity, and self-rated tic suppressibility. The mechanisms underlying the observed heterogeneity in reward-enhanced tic suppressibility warrant further investigation. The Tic Suppression Task is a promising method for testing mechanistic hypotheses related to tic suppression. PMID:29875706

Patterns and Predictors of Tic Suppressibility in Youth With Tic Disorders.

PubMed

Conelea, Christine A; Wellen, Brianna; Woods, Douglas W; Greene, Deanna J; Black, Kevin J; Specht, Matthew; Himle, Michael B; Lee, Han-Joo; Capriotti, Matthew

2018-01-01

Tic suppression is the primary target of tic disorder treatment, but factors that influence voluntary tic inhibition are not well understood. Several studies using the Tic Suppression Task have demonstrated significant inter-individual variability in tic suppressibility but have individually been underpowered to address correlates of tic suppression. The present study explored patterns and clinical correlates of reward-enhanced tic suppression in youth with tic disorders using a large, pooled dataset. Individual-level data from nine studies using the Tic Suppression Task were pooled, yielding a sample of 99 youth with tic disorders. Analyses examined patterns of tic suppressibility and the relationship between tic suppressibility and demographic and clinical characteristics. A large majority of youth demonstrated a high degree of tic suppression, but heterogeneous patterns of tic suppressibility were also observed. Better tic suppressibility was related to older age and more frequent tics but unrelated to other clinical variables, including presence of psychiatric comorbidity, psychotropic medication status, tic and premonitory urge severity, and self-rated tic suppressibility. The mechanisms underlying the observed heterogeneity in reward-enhanced tic suppressibility warrant further investigation. The Tic Suppression Task is a promising method for testing mechanistic hypotheses related to tic suppression.

Nuclear Brayton turboalternator-compressor (TAC) conceptual design study

NASA Technical Reports Server (NTRS)

Mock, E. A.; Davis, J. E.

1972-01-01

A comprehensive analysis and conceptual design study of the turboalternator-compressor components was performed using HeXe as the working fluid. Individual turbine, alternator, compressor, and bearing and seal designs were evaluated. Six turboalternator-compressor TAC configurations were completed. One TAC configuration was evaluated to calculate its performance when operating under new cycle conditions,namely, one higher and one lower turbine inlet temperature and one case with krypton as the working fluid. Based on the results, a TAC configuration that incorporated a radial compressor, a radial turbine, a Lundell Alternator, and gas bearings was selected. A new layout of the TAC was prepared that reflects the cycle state points necessary to accommodate a zirconium hydride moderated reactor and a 400 Hz alternator. The final TAC design rotates at 24,000 rpm and produces 160 kWe, 480V, 3-phase, 400 hertz power.

Tics and Tourette's: update on pathophysiology and tic control.

PubMed

Ganos, Christos

2016-08-01

To describe recent advances in the pathophysiology of tics and Tourette syndrome, and novel insights on tic control. The cortico-basal ganglia-thalamo-cortical loops are implicated in generation of tics. Disruption of GABAergic inhibition lies at the core of tic pathophysiology, but novel animal models also implicate cholinergic and histaminergic neurotransmission. Tourette syndrome patients have altered awareness of volition and enhanced formation of habits. Premonitory urges are not the driving force behind all tics. The intensity of premonitory urges depends on patients' capacity to perceive interoceptive signals. The insular cortex is a key structure in this process. The trait intensity of premonitory urges is not a prerequisite of voluntary tic inhibition, a distinct form of motor control. Voluntary tic inhibition is most efficient in the body parts that tic the least. The prefrontal cortex is associated with the capacity to inhibit tics. The management of tics includes behavioral, pharmacological and surgical interventions. Treatment recommendations differ based on patients' age. The study of Tourette syndrome pathophysiology involves different neural disciplines and provides novel, exciting insights of brain function in health and disease. These in turn provide the basis for innovative treatment approaches of tics and their associations.

A Comparison of Urge Intensity and the Probability of Tic Completion During Tic Freely and Tic Suppression Conditions.

PubMed

Specht, Matt W; Nicotra, Cassandra M; Kelly, Laura M; Woods, Douglas W; Ricketts, Emily J; Perry-Parrish, Carisa; Reynolds, Elizabeth; Hankinson, Jessica; Grados, Marco A; Ostrander, Rick S; Walkup, John T

2014-03-01

Tic-suppression-based treatments (TSBTs) represent a safe and effective treatment option for Chronic Tic Disorders (CTDs). Prior research has demonstrated that treatment naive youths with CTDs have the capacity to safely and effectively suppress tics for prolonged periods. It remains unclear how tic suppression is achieved. The current study principally examines how effective suppression is achieved and preliminary correlates of the ability to suppress tics. Twelve youths, ages 10 to 17 years, with moderate-to-marked CTDs participated in an alternating sequence of tic freely and reinforced tic suppression conditions during which urge intensity and tic frequency were frequently assessed. Probability of tics occurring was half as likely following high-intensity urges during tic suppression (31%) in contrast to low-intensity urges during tic freely conditions (60%). Age was not associated with ability to suppress. Intelligence indices were associated with or trended toward greater ability to suppress tics. Attention difficulties were not associated with ability to suppress but were associated with tic severity. In contrast to our "selective suppression" hypothesis, we found participants equally capable of suppressing their tics regardless of urge intensity during reinforced tic suppression. Tic suppression was achieved with an "across-the-board" effort to resist urges. Preliminary data suggest that ability to suppress may be associated with general cognitive variables rather than age, tic severity, urge severity, and attention. Treatment naive youths appear to possess a capacity for robust tic suppression. TSBTs may bolster these capacities and/or enable their broader implementation, resulting in symptom improvement. © The Author(s) 2014.

Toe-to-hand transfer.

PubMed

Yoshimura, M

1980-07-01

Toe-to-hand transfer was performed in 28 patients, involving 33 fingers, using microvascular technique. Of this number, 26 patients (31 fingers) had experienced trauma, and the remaining 2 patients (2 fingers) had a congenital deformity. The toew used for grafting were the great toe (1), the second tow (30), and third toe (2). Success was achieved in all cases, sensory recovery was good, and remarkable improvement was attained in function and cosmetic appearance. Metacarpal hand, amputation of thumb, and amputation thumb and three fingers were good indications for this procedure, which gave satisfactory aesthetic results, even in patients with amputation of single digits.

REWARD ENHANCES TIC SUPPRESSION IN CHILDREN WITHIN MONTHS OF TIC DISORDER ONSET

PubMed Central

Greene, Deanna J.; Koller, Jonathan M.; Robichaux-Viehoever, Amy; Bihun, Emily C.; Schlaggar, Bradley L.; Black, Kevin J.

2014-01-01

Tic disorders are childhood onset neuropsychiatric disorders characterized by motor and/or vocal tics. Research has demonstrated that children with chronic tics (including Tourette syndrome and Chronic Tic Disorder: TS/CTD) can suppress tics, particularly when an immediate, contingent reward is given for successful tic suppression. As a diagnosis of TS/CTD requires tics to be present for at least one year, children in these tic suppression studies had been living with tics for quite some time. Thus, it is unclear whether the ability to inhibit tics is learned over time or present at tic onset. Resolving that issue would inform theories of how tics develop and how behavior therapy for tics works. We investigated tic suppression in school-age children as close to the time of tic onset as possible, and no later than six months after onset. Children were asked to suppress their tics both in the presence and absence of a contingent reward. Results demonstrated that these children, like children with TS/CTD, have some capacity to suppress tics, and that immediate reward enhances that capacity. These findings demonstrate that the modulating effect of reward on inhibitory control of tics is present within months of tic onset, before tics have become chronic. PMID:25220075

Effects of toe-out and toe-in gait with varying walking speeds on knee joint mechanics and lower limb energetics.

PubMed

Khan, Soobia Saad; Khan, Saad Jawaid; Usman, Juliana

2017-03-01

Toe-out/-in gait has been prescribed in reducing knee joint load to medial knee osteoarthritis patients. This study focused on the effects of toe-out/-in at different walking speeds on first peak knee adduction moment (fKAM), second peak KAM (sKAM), knee adduction angular impulse (KAAI), net mechanical work by lower limb as well as joint-level contribution to the total limb work during level walking. Gait analysis of 20 healthy young adults was done walking at pre-defined normal (1.18m/s), slow (0.85m/s) and fast (1.43m/s) walking speeds with straight-toe (natural), toe-out (15°>natural) and toe-in (15°Toe-out gait increased fKAM at all walking speeds (highest at normal speed) while toe-in gait reduced fKAM at all speeds (highest at fast walking speed). Toeing-in reduced KAAI at all speeds while toeing-out affected KAAI only at normal speed. Increasing walking speed generally increased fKAM for all foot positions, but it did not affect sKAM considerably. Slowing down the speed, increased KAAI significantly at all foot positions except for toe-in. At slow walking speed, hip and knee joints were found to be major energy contributors for toe-in and toe-out respectively. At higher walking speeds, these contributions were switched. The ankle joint remained unaffected by changing walking speeds and foot progression angles. Toe-out/-in gait modifications affected knee joint kinetics and lower limb energetics at all walking speeds. However, their effects were inconsistent at different speeds. Therefore, walking speed should be taken into account when prescribing toe-out/-in gait. Copyright © 2017 Elsevier B.V. All rights reserved.

Reward enhances tic suppression in children within months of tic disorder onset.

PubMed

Greene, Deanna J; Koller, Jonathan M; Robichaux-Viehoever, Amy; Bihun, Emily C; Schlaggar, Bradley L; Black, Kevin J

2015-02-01

Tic disorders are childhood onset neuropsychiatric disorders characterized by motor and/or vocal tics. Research has demonstrated that children with chronic tics (including Tourette syndrome and Chronic Tic Disorder: TS/CTD) can suppress tics, particularly when an immediate, contingent reward is given for successful tic suppression. As a diagnosis of TS/CTD requires tics to be present for at least one year, children in these tic suppression studies had been living with tics for quite some time. Thus, it is unclear whether the ability to inhibit tics is learned over time or present at tic onset. Resolving that issue would inform theories of how tics develop and how behavior therapy for tics works. We investigated tic suppression in school-age children as close to the time of tic onset as possible, and no later than six months after onset. Children were asked to suppress their tics both in the presence and absence of a contingent reward. Results demonstrated that these children, like children with TS/CTD, have some capacity to suppress tics, and that immediate reward enhances that capacity. These findings demonstrate that the modulating effect of reward on inhibitory control of tics is present within months of tic onset, before tics have become chronic. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

[Hand reconstruction by microsurgical free toe transfer].

PubMed

Stamate, T; Budurcă, A R; Hermeziu, Oana

2003-01-01

Reconstruction of complex hand mutilations with multi-digital or thumb amputations are best treated with microsurgical toe transfers. We present the results of the first 15 cases operated by the first author, of which 12 are thumb reconstructions (6 great toe and 6 second toe transfers) and 3 long fingers reconstructions with combined second and third toe transfers. There were no microsurgical complications. Cortical integration and functional integration was achieved for all transferred toes, with discriminatory sensibility (m2PD between 5 and 13 mm) and active mobility range between 30 and 60 degrees.

Alarm toe switch

DOEpatents

Ganyard, Floyd P.

1982-01-01

An alarm toe switch inserted within a shoe for energizing an alarm circuit n a covert manner includes an insole mounting pad into which a miniature reed switch is fixedly molded. An elongated slot perpendicular to the reed switch is formed in the bottom surface of the mounting pad. A permanent cylindrical magnet positioned in the forward portion of the slot with a diameter greater than the pad thickness causes a bump above the pad. A foam rubber block is also positioned in the slot rearwardly of the magnet and holds the magnet in normal inoperative relation. A non-magnetic support plate covers the slot and holds the magnet and foam rubber in the slot. The plate minimizes bending and frictional forces to improve movement of the magnet for reliable switch activation. The bump occupies the knuckle space beneath the big toe. When the big toe is scrunched rearwardly the magnet is moved within the slot relative to the reed switch, thus magnetically activating the switch. When toe pressure is released the foam rubber block forces the magnet back into normal inoperative position to deactivate the reed switch. The reed switch is hermetically sealed with the magnet acting through the wall so the switch assembly S is capable of reliable operation even in wet and corrosive environments.

Tic20 forms a channel independent of Tic110 in chloroplasts

PubMed Central

2011-01-01

Background The Tic complex (Translocon at the inner envelope membrane of chloroplasts) mediates the translocation of nuclear encoded chloroplast proteins across the inner envelope membrane. Tic110 forms one prominent protein translocation channel. Additionally, Tic20, another subunit of the complex, was proposed to form a protein import channel - either together with or independent of Tic110. However, no experimental evidence for Tic20 channel activity has been provided so far. Results We performed a comprehensive biochemical and electrophysiological study to characterize Tic20 in more detail and to gain a deeper insight into its potential role in protein import into chloroplasts. Firstly, we compared transcript and protein levels of Tic20 and Tic110 in both Pisum sativum and Arabidopsis thaliana. We found the Tic20 protein to be generally less abundant, which was particularly pronounced in Arabidopsis. Secondly, we demonstrated that Tic20 forms a complex larger than 700 kilodalton in the inner envelope membrane, which is clearly separate from Tic110, migrating as a dimer at about 250 kilodalton. Thirdly, we defined the topology of Tic20 in the inner envelope, and found its N- and C-termini to be oriented towards the stromal side. Finally, we successfully reconstituted overexpressed and purified full-length Tic20 into liposomes. Using these Tic20-proteoliposomes, we could demonstrate for the first time that Tic20 can independently form a cation selective channel in vitro. Conclusions The presented data provide first biochemical evidence to the notion that Tic20 can act as a channel protein within the chloroplast import translocon complex. However, the very low abundance of Tic20 in the inner envelope membranes indicates that it cannot form a major protein translocation channel. Furthermore, the independent complex formation of Tic20 and Tic110 argues against a joint channel formation. Thus, based on the observed channel activity of Tic20 in proteoliposomes, we

Toe transfer in congenital hand malformations.

PubMed

Foucher, G; Medina, J; Navarro, R; Nagel, D

2001-01-01

Fifty-eight patients with congenital hand abnormalities underwent 65 toe-to-hand transfers. Symbrachydactyly (51 cases) was the most frequent indication. Forty-seven second toe-to-hand transfers were performed in 44 patients. The mean follow-up time was 5.2 years. Two failures occurred in cases in which only one artery was anastomosed; no failures were noted when more than one artery fed the transfer. Two patients with a single second-toe transfer presented with lateral instability of the transferred metatarsophalangeal joint. The mean active range of motion was 38 degrees, with a mean extension lag of 25 degrees. The mean two-point discrimination was 5 mm. Forty-one patients used the transferred toe well, when performing activities of daily living and playing games. Toe-to-hand transfer, prior to the establishment of the grip pattern, facilitates integration of the transfer.

Variables Associated With Tic Exacerbation in Children With Chronic Tic Disorders

PubMed Central

Himle, Michael B.; Capriotti, Matthew R.; Hayes, Loran P.; Ramanujam, Krishnapriya; Scahill, Lawrence; Sukhodolsky, Denis G.; Wilhelm, Sabine; Deckersbach, Thilo; Peterson, Alan L.; Specht, Matt W.; Walkup, John T.; Chang, Susanna; Piacentini, John

2014-01-01

Research has shown that motor and vocal tics fluctuate in frequency, intensity, and form in response to environmental and contextual cues. Behavioral models have proposed that some of the variation in tics may reflect context-dependent interactive learning processes such that once tics are performed, they are influenced by environmental contingencies. The current study describes the results of a function-based assessment of tics (FBAT) from a recently completed study comparing Comprehensive Behavioral Intervention for Tics (CBIT) with supportive psychotherapy. The current study describes the frequency with which antecedent and consequence variables were reported to exacerbate tics and the relationships between these functional variables and sample baseline characteristics, comorbidities, and measures of tic severity. Results showed that tic-exacerbating antecedents and consequences were nearly ubiquitous in a sample of children with chronic tic disorder. In addition, functional variables were related to baseline measures of comorbid internalizing symptoms and specific measures of tic severity. PMID:24778433

Variables Associated With Tic Exacerbation in Children With Chronic Tic Disorders.

PubMed

Himle, Michael B; Capriotti, Matthew R; Hayes, Loran P; Ramanujam, Krishnapriya; Scahill, Lawrence; Sukhodolsky, Denis G; Wilhelm, Sabine; Deckersbach, Thilo; Peterson, Alan L; Specht, Matt W; Walkup, John T; Chang, Susanna; Piacentini, John

2014-03-01

Research has shown that motor and vocal tics fluctuate in frequency, intensity, and form in response to environmental and contextual cues. Behavioral models have proposed that some of the variation in tics may reflect context-dependent interactive learning processes such that once tics are performed, they are influenced by environmental contingencies. The current study describes the results of a function-based assessment of tics (FBAT) from a recently completed study comparing Comprehensive Behavioral Intervention for Tics (CBIT) with supportive psychotherapy. The current study describes the frequency with which antecedent and consequence variables were reported to exacerbate tics and the relationships between these functional variables and sample baseline characteristics, comorbidities, and measures of tic severity. Results showed that tic-exacerbating antecedents and consequences were nearly ubiquitous in a sample of children with chronic tic disorder. In addition, functional variables were related to baseline measures of comorbid internalizing symptoms and specific measures of tic severity. © The Author(s) 2014.

Chronic motor tic disorder

MedlinePlus

Chronic vocal tic disorder; Tic - chronic motor tic disorder ... Chronic motor tic disorder is more common than Tourette syndrome . Chronic tics may be forms of Tourette syndrome. Tics usually start ...

Comparison of Two Alternative Methods for Tracking Toe Trajectory

NASA Technical Reports Server (NTRS)

Miller, Chris; Peters, Brian; Brady, Rachel; Mulavara, Ajitkumar; Warren, Liz; Feiveson, Al; Bloomberg, Jacob

2007-01-01

Toe trajectory during the swing phase of locomotion has been identified as a precise motor control task (Karst, et al., 1999). The standard method for tracking toe trajectory is to place a marker on the superior aspect of the distal end of the 2nd toe itself (Karst, et al., 1999; Winter, 1992). However, others have based their toe trajectory results either on a marker positioned on the lateral aspect of the 5th metatarsal head (Dingwell, et al., 1999; Osaki, et al., 2007), or on a virtual toe marker computed at the anterior tip of the second toe based on the positions of other real foot markers (Miller, et al., 2006). While these methods for tracking the toe may seem similar, their results may not be directly comparable. The purpose of this study was to compute toe trajectory parameters using a 5th metatarsal marker and a virtual toe marker, and compare their results with those of the standard toe marker.

[Post-traumatic tics].

PubMed

Alegre, S; Chacón, J; Redondo, L; Navarro-Busto, C; Solana, B

1996-10-01

Secondary tics are those in which an aetiology justifying them can be found, as compared to idiopathic tics, which make up the majority, and the Gilles de la Tourette syndrome (SGT), which is, at the moment, of unknown origin. Of the possible aetiologies described as causing tics, craneo-encephalic trauma has been mentioned on very few occasions. We present a case of post-traumatic tics (verbal and neck) in a young man of 24, and review the published cases which can be considered to be of post-traumatic tics. We have found six cases of tics secondary to traumas, all craneo-encephalic, like ours (the one under study). The time interval between the blow and the appearance of the tic or tics varied between 2 weeks and 3 months. The absence of significant lesions seen in the complementary investigations make it impossible for us to discover the site of the lesion caused by the trauma. However, the presence in some cases of other tics before the trauma, and of family histories of tics, supports the idea of a genetic basis or predisposition to suffer this disorder.

Young Children's Reasoning in Games of Nonsocial and Social Logic: "Tic Tac Toe" and a "Guessing Game."

ERIC Educational Resources Information Center

Fernie, David E.; DeVries, Rheta

1990-01-01

A total of 87 children, 3- to 7-years old, were examined in a study of children's play and reasoning in games of mathematical logic and social logic. Children's sophistication in reasoning was positively related for two games, suggesting a common three-level progression from mastery of procedures to a competitive attitude to advanced strategy. (SH)

Phenomenology of tics and natural history of tic disorders.

PubMed

Leckman, James F

2003-12-01

Tic symptoms, the hallmark of Tourette's syndrome (TS), may simply be fragments of innate behavior. As such, the sensory urges that precede tics may illuminate some of the normal internal cues that are intimately involved in the assembly of behavioral sequences. The occurrence of tics in time appears to have fractal characteristics that may help to explain the waxing and waning course of tic disorders. Longitudinal studies are currently underway that should permit a close examination of the natural fluctuations in tic severity using valid and reliable clinician-rated scales of tic severity. The natural history of tics typically shows a marked decline during the course of adolescence. However, TS can also be associated with social, emotional, and academic difficulties in early adulthood. Comorbid attention deficit/hyperactivity disorder and obsessive-compulsive disorder are likely to influence the long-term adaptive outcomes of individuals with TS. Future progress may also be expected as endophenotypes, and possibly genetic markers, are identified that are associated with specific comorbid conditions and etiologically distinct forms of TS.

Amygdala-Dependent Molecular Mechanisms of the Tac2 Pathway in Fear Learning

PubMed Central

Andero, Raül; Daniel, Sarah; Guo, Ji-Dong; Bruner, Robert C; Seth, Shivani; Marvar, Paul J; Rainnie, Donald; Ressler, Kerry J

2016-01-01

Recently we determined that activation of the tachykinin 2 (Tac2) pathway in the central amygdala (CeA) is necessary and sufficient for the modulation of fear memories. The Tac2 pathway includes the Tac2 gene, which encodes the neuropeptide neurokinin B and its corresponding receptor neurokinin 3 receptor (NK3R). In this study, using Tac2–cre and Tac2–GFP mice, we applied a combination of in vivo (optogenetics) and multiple in vitro techniques to further explore the mechanisms of action within the Tac2 pathway. In transgenic mice that express ChR2 solely in Tac2 neurons, in vivo optogenetic stimulation of CeA Tac2-expressing neurons during fear acquisition enhanced fear memory consolidation and drove action potential firing in vitro. In addition, Tac2–CeA neurons were shown to co-express striatal-enriched protein tyrosine phosphatase, which may have an important role in regulating Nk3R signaling during fear conditioning. These data extend our current understanding for the underlying mechanism(s) for the role of the Tac2 pathway in the regulation of fear memory, which may serve as a new therapeutic target in the treatment of fear-related disorders. PMID:27238620

Plasma total antioxidant capacity (TAC) in obese Malaysian subjects.

PubMed

Lim, S H; Fan, S H; Say, Y H

2012-12-01

There is a pressing need to better understand the complex biochemical pathways that lead to the pathogenesis of obesity. Increased oxidative stress and decreased antioxidant capacity have been identified to be associated with obesity. Therefore, the objectives of this study were to determine the plasma total antioxidant capacity (TAC) levels of Malaysian subjects and to evaluate its potential association with obesity and related anthropometric measurements. Plasma TAC of 362 multi-ethnic Malaysian subjects from the Kampar Health Clinic (138 males, 224 females; 124 ethnic Malays, 152 Chinese, 86 Indians; 192 non-obese, 170 obese) was measured using Trolox equivalent antioxidant capacity (TEAC) 96-well plate assay. Plasma TAC was significantly lower in obese subjects (M +/- SE = 292 +/- 10.4 micromol/L) compared to non-obese subjects (397 +/- 8.58 micromol/L), whereas it was significantly higher in males and those in the 21-30 age group. Those with salty food preference and practising a strict vegetarian diet also had significantly higher plasma TAC. However, no association was found for other dietary habits (coffee intake) and lifestyle factors (physical activity, smoking). Plasma TAC was also significantly negatively correlated with diastolic blood pressure, waist and hip circumferences, weight, body mass index, total body fat, % subcutaneous fat, visceral fat level, resting metabolism and % skeletal muscle. Plasma TAC was found to be associated with obesity, strict vegetarian practice, salty food preference and all obesity anthropometric indicators, except systolic blood pressure and pulse rate. Obese people have decreased plasma TAC indicating a compromised systemic antioxidant defence and increased oxidative stress.

Effects of toe-in and toe-in with wider step width on level walking knee biomechanics in varus, valgus, and neutral knee alignments.

PubMed

Bennett, Hunter J; Shen, Guangping; Cates, Harold E; Zhang, Songning

2017-12-01

Increased peak external knee adduction moments exist for individuals with knee osteoarthritis and varus knee alignments, compared to healthy and neutrally aligned counterparts. Walking with increased toe-in or increased step width have been individually utilized to successfully reduce 1st and 2nd peak knee adduction moments, respectfully, but have not previously been combined or tested among all alignment groups. The purpose of this study was to compare toe-in only and toe-in with wider step width gait modifications in individuals with neutral, valgus, and varus alignments. Thirty-eight healthy participants with confirmed varus, neutral, or valgus frontal-plane knee alignment through anteroposterior radiographs, performed level walking in normal, toe-in, and toe-in with wider step width gaits. A 3×3 (group×intervention) mixed model repeated measures ANOVA compared alignment groups and gait interventions (p<0.05). The 1st peak knee adduction moment was reduced in both toe-in and toe-in with wider step width compared to normal gait. The 2nd peak adduction moment was increased in toe-in compared to normal and toe-in with wider step width. The adduction impulse was also reduced in toe-in and toe-in with wider step width compared to normal gait. Peak knee flexion and external rotation moments were increased in toe-in and toe-in with wider step width compared to normal gait. Although the toe-in with wider step width gait seems to be a viable option to reduce peak adduction moments for varus alignments, sagittal, and transverse knee loadings should be monitored when implementing this gait modification strategy. Copyright © 2017 Elsevier B.V. All rights reserved.

Frequency-dependent tACS modulation of BOLD signal during rhythmic visual stimulation.

PubMed

Chai, Yuhui; Sheng, Jingwei; Bandettini, Peter A; Gao, Jia-Hong

2018-05-01

Transcranial alternating current stimulation (tACS) has emerged as a promising tool for modulating cortical oscillations. In previous electroencephalogram (EEG) studies, tACS has been found to modulate brain oscillatory activity in a frequency-specific manner. However, the spatial distribution and hemodynamic response for this modulation remains poorly understood. Functional magnetic resonance imaging (fMRI) has the advantage of measuring neuronal activity in regions not only below the tACS electrodes but also across the whole brain with high spatial resolution. Here, we measured fMRI signal while applying tACS to modulate rhythmic visual activity. During fMRI acquisition, tACS at different frequencies (4, 8, 16, and 32 Hz) was applied along with visual flicker stimulation at 8 and 16 Hz. We analyzed the blood-oxygen-level-dependent (BOLD) signal difference between tACS-ON vs tACS-OFF, and different frequency combinations (e.g., 4 Hz tACS, 8 Hz flicker vs 8 Hz tACS, 8 Hz flicker). We observed significant tACS modulation effects on BOLD responses when the tACS frequency matched the visual flicker frequency or the second harmonic frequency. The main effects were predominantly seen in regions that were activated by the visual task and targeted by the tACS current distribution. These findings bridge different scientific domains of tACS research and demonstrate that fMRI could localize the tACS effect on stimulus-induced brain rhythms, which could lead to a new approach for understanding the high-level cognitive process shaped by the ongoing oscillatory signal. © 2018 Wiley Periodicals, Inc.

Visual feedback of own tics increases tic frequency in patients with Tourette's syndrome.

PubMed

Brandt, V C; Lynn, M T; Obst, M; Brass, M; Münchau, A

2015-01-01

Gilles de la Tourette syndrome (GTS) is characterized by motor and phonic tics. It is unknown how paying attention to one's own tics might modulate tic frequency. We determined tic frequency in freely ticcing GTS patients while they were being filmed. In Study 1, we investigated 12 patients (1) alone in a room (baseline); (2) alone in front of a mirror. In Study 2, we replicated these conditions in 16 patients and additionally examined how watching a video, in which the individual was shown not ticcing, affected their tic frequency. In both studies, tic frequency was significantly higher when patients watched themselves in a mirror compared to baseline. In contrast, tic frequency was significantly reduced in the video condition. Paying attention to one's own tics increases tic frequency when tics are not suppressed and appears to be specific for attention to tics, rather than attention to the self.

Toe pressure determination by audiophotoplethysmography.

PubMed

Fronek, A; Blazek, V; Curran, B

1994-08-01

The purpose of this study was to evaluate the performance of audiophotoplethysmography as a modality to measure toe pressure without the requirement of a recorder. A portable photoplethysmograph with an audio output was used to determine toe pressures, and the results were compared with those obtained by a commercial photoplethysmograph with a recorder. Thirty-one measurements in control subjects and 62 measurements in patients with arterial occlusive disease were performed. The average toe pressure recorded with oscillography with standard photoplethysmography was 103.5 mm Hg +/- 14.7 SD and 95.9 mm Hg +/- 13.4 SD with audio-photoplethysmography. In the patient group the pressure recorded with a commercial photoplethysmograph was 65.3 mm Hg +/- 34.9 SD compared with 61.6 mm Hg +/- 34.8 SD obtained with audio-photoplethysmography. The difference in both groups was insignificant, and the correlation between both methods was very good. A portable hand-held photoplethysmograph equipped with an audio output was used to measure toe pressure in control subjects and in patients with arterial occlusive disease. The results have been compared with the oscillometric method by a standard commercial photoplethysmograph connected to a recorder. The correlation was very good in the control and patient groups, and the difference between both methods was below the level of statistical significance. The fact that no recorder is needed may help in introducing toe pressure measurement into everyday office diagnostic practice.

The Effects of Theta and Gamma tACS on Working Memory and Electrophysiology

PubMed Central

Pahor, Anja; Jaušovec, Norbert

2018-01-01

A single blind sham-controlled study was conducted to explore the effects of theta and gamma transcranial alternating current stimulation (tACS) on offline performance on working memory tasks. In order to systematically investigate how specific parameters of tACS affect working memory, we manipulated the frequency of stimulation (theta frequency vs. gamma frequency), the type of task (n-back vs. change detection task) and the content of the tasks (verbal vs. figural stimuli). A repeated measures design was used that consisted of three sessions: theta tACS, gamma tACS and sham tACS. In total, four experiments were conducted which differed only with respect to placement of tACS electrodes (bilateral frontal, bilateral parietal, left fronto-parietal and right-fronto parietal). Healthy female students (N = 72) were randomly assigned to one of these groups, hence we were able to assess the efficacy of theta and gamma tACS applied over different brain areas, contrasted against sham stimulation. The pre-post/sham resting electroencephalogram (EEG) analysis showed that theta tACS significantly affected theta amplitude, whereas gamma tACS had no significant effect on EEG amplitude in any of the frequency bands of interest. Gamma tACS did not significantly affect working memory performance compared to sham, and theta tACS led to inconsistent changes in performance on the n-back tasks. Active theta tACS significantly affected P3 amplitude and latency during performance on the n-back tasks in the bilateral parietal and right-fronto parietal protocols. PMID:29375347

Alarm toe switch. [Patent application

DOEpatents

Ganyard, F.P.

1980-11-18

An alarm toe switch inserted within a shoe for energizing an alarm circuit in a covert manner includes an insole mounting pad into which a miniature reed switch is fixedly molded. An elongated slot perpendicular to the reed switch is formed in the bottom surface of the mounting pad. A permanent cylindrical magnet positioned in the forward portion of the slot with a diameter greater than the pad thickness causes a bump above the pad. A foam rubber block is also positioned in the slot rearwardly of the magnet and holds the magnet in normal inoperative relation. A non-magnetic support plate covers the slot and holds the magnet and foam rubber in the slot. The plate minimizes bending and frictional forces to improve movement of the magnet for reliable switch activation. The bump occupies the knuckle space beneath the big toe. When the big toe is scrunched rearwardly the magnet is moved within the slot relative to the reed switch, thus magnetically activating the switch. When toe pressure is released the foam rubber block forces the magnet back into normal inoperative position to deactivate the reed switch.

Adapting Price Predictions in TAC SCM

NASA Astrophysics Data System (ADS)

Pardoe, David; Stone, Peter

In agent-based markets, adapting to the behavior of other agents is often necessary for success. When it is not possible to directly model individual competitors, an agent may instead model and adapt to the market conditions that result from competitor behavior. Such an agent could still benefit from reasoning about specific competitor strategies by considering how various combinations of these strategies would impact the conditions being modeled. We present an application of such an approach to a specific prediction problem faced by the agent TacTex-06 in the Trading Agent Competition's Supply Chain Management scenario (TAC SCM).

The role of parental perceptions of tic frequency and intensity in predicting tic-related functional impairment in youth with chronic tic disorders.

PubMed

Espil, Flint M; Capriotti, Matthew R; Conelea, Christine A; Woods, Douglas W

2014-12-01

Tic severity is composed of several dimensions. Tic frequency and intensity are two such dimensions, but little empirical data exist regarding their relative contributions to functional impairment in those with chronic tic disorders (CTD). The present study examined the relative contributions of these dimensions in predicting tic-related impairment across several psychosocial domains. Using data collected from parents of youth with CTD, multivariate regression analyses revealed that both tic frequency and intensity predicted tic-related impairment in several areas; including family and peer relationships, school interference, and social endeavors, even when controlling for the presence of comorbid anxiety symptoms and Attention Deficit Hyperactivity Disorder diagnostic status. Results showed that tic intensity predicted more variance across more domains than tic frequency.

The Role of Parental Perceptions of Tic Frequency and Intensity in Predicting Tic-Related Functional Impairment in Youth with Chronic Tic Disorders

PubMed Central

Espil, Flint M.; Capriotti, Matthew R.; Conelea, Christine A.; Woods, Douglas W.

2014-01-01

Tic severity is composed of several dimensions. Tic frequency and intensity are two such dimensions, but little empirical data exist regarding their relative contributions to functional impairment in those with Chronic Tic Disorders (CTD). The present study examined the relative contributions of these dimensions in predicting tic-related impairment across several psychosocial domains. Using data collected from parents of youth with CTD, multivariate regression analyses revealed that both tic frequency and intensity predicted tic-related impairment in several areas; including family and peer relationships, school interference, and social endeavors, even when controlling for the presence of comorbid anxiety symptoms and Attention Deficit Hyperactivity Disorder diagnostic status. Results showed that tic intensity predicted more variance across more domains than tic frequency. PMID:24395287

Toe-to-hand transfer: Evolving Indications and Relevant Outcomes

PubMed Central

Waljee, Jennifer F.; Chung, Kevin C.

2014-01-01

In the late 19th century, the first toe to hand transfer was performed in Vienna, Switzerland as a staged procedure by Nicolandi.(1) Since that time, the advent of microsurgery has revolutionized toe to hand transfers. In 1966, Buncke performed the first microvascular toe to thumb transfer in a rhesus monkey.(2) The first toe to thumb transfer using microsurgical techniques in humans was performed by Cobbett in 1969, followed shortly thereafter by the first transfer of a second toe to the thumb position.(3,4) Today, due to expanding microsurgical techniques and surgeon innovation, the indications and techniques for toe-to-hand transfer procedures continue to evolve and now encompass patients with a variety of acquired and congenital hand defects.(5) PMID:23790426

Tics and Tourette Syndrome

MedlinePlus

... for Nausea and Vomiting Home Diseases and Conditions Tics and Tourette Syndrome Condition Tics and Tourette Syndrome Share Print Table of Contents1. ... little or no control over. These are called tics. Several different tics can happen at the same ...

TacSat-4 COMMx, Advanced SATCOM Experiment

DTIC Science & Technology

2009-01-01

Schein, M. T. Marley, C. T. Apland, R. E. Lee, B. D . Williams, E. D . Schaefer, S. R. Vernon, P . D . Schwartz , B. L. Kantsiper, E. J. Finnegan;The...Lee, B. D . Williams, E. D . Schaefer, P . D . Schwartz, R. Denissen, B. Kantsiper, E. J. Finnegan; The Johns Hopkins University Applied Physics...Mission Ops Lead, NRL Code 8233 Bob Kuzma, TacSat-4 Payload Controller, NRL Code 8242 Bob Skalitzky, TacSat-4 Power Systems, NRL Code 8244 Doug Bentz

Hammer toe

MedlinePlus

... by: C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Toe Injuries and Disorders Read more NIH MedlinePlus ...

Bothersome Tics in Patients with Chronic Tic Disorders: Characteristics and Individualized Treatment Response to Behavior Therapy

PubMed Central

McGuire, Joseph F.; Piacentini, John; Scahill, Lawrence; Woods, Douglas W.; Villarreal, Robert; Wilhelm, Sabine; Walkup, John T.; Peterson, Alan L.

2015-01-01

This report examined the most frequently reported bothersome tics among individuals with chronic tic disorders and evaluated the improvement and remission of tics and their associated characteristics. Youths and adults (N = 240) were randomly assigned to receive the comprehensive behavioral intervention for tics (CBIT) or psychoeducation and supportive therapy (PST). At baseline, motor tics and tics with an urge were rated as more bothersome relative to vocal tics and tics without premonitory urges. The five most common bothersome tics included eye blinking, head jerks, sniffing, throat clearing, and other complex motor tics. While CBIT outperformed PST across tic type and urge presence, tics preceded by premonitory urges at baseline had higher severity at posttreatment across treatment condition. Six individual tic types had lower severity at posttreatment following CBIT relative to PST. Baseline urge presence was associated with tic remission for CBIT but not PST. Specific bothersome tics were more likely to remit with CBIT relative to PST. Findings suggest that individual tics respond and remit differently to CBIT relative to PST, with implications highlighting the negative reinforcement hypothesis in tic symptom maintenance. PMID:25988365

Bothersome tics in patients with chronic tic disorders: Characteristics and individualized treatment response to behavior therapy.

PubMed

McGuire, Joseph F; Piacentini, John; Scahill, Lawrence; Woods, Douglas W; Villarreal, Robert; Wilhelm, Sabine; Walkup, John T; Peterson, Alan L

2015-07-01

This report examined the most frequently reported bothersome tics among individuals with chronic tic disorders and evaluated the improvement and remission of tics and their associated characteristics. Youths and adults (N = 240) were randomly assigned to receive the comprehensive behavioral intervention for tics (CBIT) or psychoeducation and supportive therapy (PST). At baseline, motor tics and tics with an urge were rated as more bothersome relative to vocal tics and tics without premonitory urges. The five most common bothersome tics included eye blinking, head jerks, sniffing, throat clearing, and other complex motor tics. While CBIT outperformed PST across tic type and urge presence, tics preceded by premonitory urges at baseline had higher severity at posttreatment across treatment condition. Six individual tic types had lower severity at posttreatment following CBIT relative to PST. Baseline urge presence was associated with tic remission for CBIT but not PST. Specific bothersome tics were more likely to remit with CBIT relative to PST. Findings suggest that individual tics respond and remit differently to CBIT relative to PST, with implications highlighting the negative reinforcement hypothesis in tic symptom maintenance. CLINICALTRIALS. NCT00218777; NCT00231985. Published by Elsevier Ltd.

Patterned changes in urge ratings with tic suppression in youth with chronic tic disorders.

PubMed

Brabson, Laurel A; Brown, Jessica L; Capriotti, Matthew R; Ramanujam, Krishnapriya; Himle, Michael B; Nicotra, Cassandra M; Ostrander, Rick; Kelly, Laura M; Grados, Marco A; Walkup, John T; Perry-Parrish, Carisa; Reynolds, Elizabeth K; Hankinson, Jessica C; Specht, Matt W

2016-03-01

Premonitory urges are central to emerging behavioral models of chronic tic disorders (CTD). Urge reduction has been proposed as a behavioral explanation for tic maintenance and exacerbation as well as the efficacy of behavioral treatments. Prior investigations have produced inconsistent findings despite common methodologies. The current study evaluated the possibility that data aggregation obscures distinct and meaningful patterns of change in urge ratings when tics are freely expressed versus suppressed. Participants (n = 12) included children with moderate-to-marked tic severity and noticeable premonitory urges. Tic frequencies and urge ratings were obtained at 15 s and 10-s intervals, respectively, across an alternating sequence of 10-min tic freely and 40-min tic suppression conditions. Patterns were established using a two step approach. Five distinct patterns of urge rating change emerged, suggesting data aggregation may obscure meaningful patterns in the urge-tic relationship when tics are completed versus suppressed. Eligibility criteria may have unintentionally excluded younger affected children and included older participants with more severe tic disorders than commonly seen. Additional research with less stringent eligibility criteria and a larger sample size will help validate the results. The relationship between urges and tics is much more complex than previously theorized. Investigations that rely on global assessments of urge and tic severity and/or assume uniformity when aggregating participant data may obscure meaningful differences in the urge-tic relationship. Future investigations should examine the possibility that individual differences and/or developmental considerations modulate the functional urge-tic relationship. Copyright © 2015. Published by Elsevier Ltd.

Tourette Syndrome and Chronic Tic Disorders: The Clinical Spectrum Beyond Tics.

PubMed

Martino, Davide; Ganos, Christos; Pringsheim, Tamara M

2017-01-01

The clinical surveillance and active management of Tourette syndrome (TS) and other primary chronic tic disorders cannot be limited to tics, as these patients manifest a spectrum of sensory-, behavioral-, cognitive-, and sleep-related problems that have a major impact on their functioning and quality of life, influencing enormously clinical decision making on a routine basis. The sensory phenomena of primary tic disorders consist of premonitory urges and heightened sensitivity to external somatosensory and interoceptive stimuli. Recent evidence suggests that raised interoceptive awareness may be related to the classical premonitory urges associated with tics. The burden of behavioral comorbidities is very important in determining the degree of disability of patients with primary tic disorders. Only 10%-15% of these patients presents exclusively with a tic disorder. Obsessive-compulsive disorder (OCD) are common in TS, and the clinical distinction between compulsions and complex tics may be difficult in some cases. "Tic-related OCD" represents a phenomenologically characteristic subtype of OCD, also associated with "just right" phenomena. Probably the presence of comorbid attention deficit/hyperactivity disorder is the main determinant of cognitive dysfunction in TS patients and influences heavily also the risk of developing disruptive behaviors. Mood and anxiety disorders, impulse control disorders, rage attacks, "impulsive" tic-like behaviors (e.g., nonobscene socially inappropriate behaviors, and self-injurious behaviors), and autism spectrum disorders complete the wide psychopathological spectrum of primary chronic tic disorders. Moreover, specific sleep abnormalities have been reported in TS patients, although more research is needed on this specific clinical problem. As in other areas of clinical neuroscience, a comprehensive approach to both motor and nonmotor aspects of this group of disorders will help personalizing treatment interventions and, ultimately

Urinary corticosterone responses to capture and toe-clipping in the cane toad (Rhinella marina) indicate that toe-clipping is a stressor for amphibians.

PubMed

Narayan, Edward J; Molinia, Frank C; Kindermann, Christina; Cockrem, John F; Hero, Jean-Marc

2011-11-01

Toe-clipping, the removal of one or more toes, is a common method used to individually mark free-living animals. Whilst this method is widely used in studies of amphibians, the appropriateness of the method, and its potential detrimental effects have been the subject of debate. Here, we provide for the first time, evidence that toe-clipping is a stressor in a wild amphibian. We measured urinary corticosterone responses of male cane toads (Rhinella marina) to capture and handling only, and to toe-clipping under field conditions. Urinary testosterone concentrations and white blood cell proportions were also measured. Urinary corticosterone metabolite concentrations increased 6h after capture and handling only and remained high for 24h; corticosterone returned to baseline levels after 48 h and remained low at 72 h post capture and handling. Corticosterone concentrations in toads subjected to toe-clipping increased at 6h to significantly higher concentrations than after capture and handling only, then decreased more slowly than after capture and handling, and were still elevated (approximately double basal level) 72 h after toe-clipping. Testosterone did not change significantly after capture and handling only, whereas after toe-clipping testosterone decreased at 6h and remained low at 72 h. There were weak short-term effects of toe-clipping compared with capture and handling only on white blood cell proportions. We have clearly shown that toe-clipping is a distinctly stronger stressor than capture and handling alone. This indicates that there is an ethical cost of toe-clipping, and this should be considered when planning studies of amphibians. Copyright © 2011 Elsevier Inc. All rights reserved.

Tics after traumatic brain injury.

PubMed

Ranjan, Nishant; Nair, Krishnan Padmakumari Sivaraman; Romanoski, Charles; Singh, Rajiv; Venketswara, Guruprasad

2011-01-01

Tics are involuntary non-rhythmic, stereotyped muscle contractions which can be suppressed temporarily. Tics usually start during childhood as part of Tourette syndrome. Adult onset tics are infrequent. This study reports on an adult man who developed tics 1 year after severe traumatic brain injury (TBI). Case report and review of literature. A 19-year-old man sustained TBI following a road traffic accident. He did not have tics or features of obsessive compulsive disorder before the brain injury. A year after injury he developed motor and vocal tics. Magnetic resonance image of the brain showed lesions in the basal ganglia. A search of databases Medline, EMBASE and CINHAL found only four publications on tics in adults with TBI. None of these reported cases had lesions in the basal ganglia. Tics are a rare complication of TBI. People with early onset post-traumatic tics may have had a previously unrecognized, mild tic disorder or a genetic predisposition for tics, which was unmasked by the TBI. In contrast, late post-traumatic tics could be due to delayed effects of injury on neural circuits connecting the frontal cortex and basal ganglia.

[Second toe transfer in congenital hand differences].

PubMed

Dautel, G; Barbary, S

2008-12-01

In congenital hand differences, microsurgical toe transfer involves the creation of one or several rays in a child that never possessed them before. Second toe transplantation was uniformly used in this series that include 65 consecutive cases. Etiologies were represented by symbrachydactyly, constriction band syndrome or central cleft hand. Second toe transfer was performed with or without the MTP joint and followed by proximal ray resection of the donor toe. In the vast majority of theses cases, transplantation was performed in adactylic or monodactylic hand, the ultimate functional goal was the creation of a "tip-to-tip" two fingers pinch. Implantation site was chosen according to the situation of the existing finger(s). The existence of a functioning recipient MCP joint was one of the key factors of the final functional outcome. There were two vascular failures in this series with complete necrosis of the transplanted toe. Two additional toes appeared mediocre with respect to the overall transfer integration. The final mobility of the fingers reconstructed was measured using the total active motion score. Average TAM was poor (42 degrees +/-24 degrees ). In 12 out of 15 patients that were evaluated with a follow-up of at least five years, the static two-point discrimination was found to be excellent (less than 6mm). Our series did not allow us to establish a firm correlation between the type of nerve suture used and the quality of sensory recovery. Growth was measured as a percentage of the intact second toe (68 to 95%). All children on a long term basis had a normal gait without any impediment during sports or leisure activities. Clinical results obtained in this series lead to think that the cerebral cortex has got some plasticity which allows the integration of the transplants.

Hammer toe repair

MedlinePlus

... causing: Pain Irritation Sores Problems finding shoes that fit Skin infections Surgery may not be advised if: Treatment with paddings and strapping works You can still straighten your toe Changing to different shoe types can alleviate symptoms

Interaction Studies of Ceramic Vacuum Plasma Spraying for the Melting Crucible Materials

DOE Office of Scientific and Technical Information (OSTI.GOV)

Jong Hwan Kim; Hyung Tae Kim; Yoon Myung Woo

2013-10-01

Candidate coating materials for re-usable metallic nuclear fuel crucibles, TaC, TiC, ZrC, ZrO2, and Y2O3, were plasmasprayed onto a niobium substrate. The microstructure of the plasma-sprayed coatings and thermal cycling behavior were characterized, and U-Zr melt interaction studies were carried out. The TaC and Y2O3 coating layers had a uniform thickness, and high density with only a few small closed pores showing good consolidation, while the ZrC, TiC, and ZrO2 coatings were not well consolidated with a considerable amount of porosity. Thermal cycling tests showed that the adhesion of the TiC, ZrC, and ZrO2 coating layers with niobium was relativelymore » weak compared to the TaC and Y2O3 coatings. The TaC and Y2O3 coatings had better cycling characteristics with no interconnected cracks. In the interaction studies, ZrC and ZrO2 coated rods showed significant degradations after exposure to U-10 wt.% Zr melt at 1600 degrees C for 15 min., but TaC, TiC, and Y2O3 coatings showed good compatibility with U-Zr melt.« less

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

21 CFR 888.3720 - Toe joint polymer constrained prosthesis.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Toe joint polymer constrained prosthesis. 888.3720... (CONTINUED) MEDICAL DEVICES ORTHOPEDIC DEVICES Prosthetic Devices § 888.3720 Toe joint polymer constrained prosthesis. (a) Identification. A toe joint polymer constrained prosthesis is a device made of silicone...

Nonvascularized toe phalangeal transfer and distraction lengthening for symbrachydactyly.

PubMed

Patterson, Ryan W; Seitz, William H

2010-04-01

Symbrachydactyly describes a spectrum of congenital hand differences consisting of digital loss resulting in fused short fingers. As the principles for distraction lengthening have evolved, the technique of nonvascularized toe phalangeal transfer to the hand with shortened digits has provided patients with improved outcomes. Nonvascularized toe phalanx to hand transplant with distraction lengthening restores functional length to a skeletally deficient, poorly functioning hand while maintaining an overlying layer of vascular and sensate tissue. The primary goal is improvement of digital length to enhance mechanical advantage and prehension. We describe the technique of nonvascularized toe phalangeal transfer and distraction lengthening for symbrachydactyly, including the following steps: nonvascularized proximal toe phalanx harvest, toe phalanx transfer to hand, pin placement, osteotomy, and closure.

Toe spreading ability in men with chronic pelvic pain syndrome

PubMed Central

Yilmaz, Ugur; Rothman, Ivan; Ciol, Marcia A; Yang, Claire C; Berger, Richard E

2005-01-01

Background We examined toe-spreading ability in subjects with chronic pelvic pain syndrome (CPPS) to test the hypothesis that subjects with CPPS could have deficiencies in lower extremity functions innervated by sacral spinal roots. Methods Seventy two subjects with CPPS and 98 volunteer controls were examined as part of a larger study on CPPS. All the subjects underwent a detailed urologic and neurological examination including a toe-spreading examination with a quantitative scoring system. We compared the groups in terms of ability of toe-spreading as either "complete" (all toes spreading) or "incomplete" (at least one interdigital space not spreading) and also by comparing the number of interdigital spaces. For CPPS subjects only, we also analyzed the variation of the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) scales by toe-spreading categories. Results CPPS subjects were less often able to spread all toes than subjects without CPPS (p = 0.005). None of the NIH-CPSI sub-scales (pain, urinary symptoms, and quality of life), nor the total score showed an association with toe spreading ability. Conclusion We found toe spreading to be diminished in subjects with CPPS. We hypothesize that incomplete toe spreading in subjects with CPPS may be related to subtle deficits involving the most caudal part of the spinal segments. PMID:15949041

Tic-Related Versus Tic-Free Obsessive-Compulsive Disorder: Clinical Picture and 2-Year Natural Course.

PubMed

de Vries, Froukje E; Cath, Danielle C; Hoogendoorn, Adriaan W; van Oppen, Patricia; Glas, Gerrit; Veltman, Dick J; van den Heuvel, Odile A; van Balkom, Anton J L M

2016-10-01

The tic-related subtype of obsessive-compulsive disorder (OCD) has a distinct clinical profile. The course of tic-related OCD has previously been investigated in treatment studies, with inconclusive results. This study aimed to compare clinical profiles between tic-related and tic-free OCD patients and to establish the influence of tics on the 2-year natural course in adult OCD patients. Within the Netherlands OCD Association cohort, 377 patients with a current DSM-IV diagnosis of OCD were divided into a tic-related group (28%) and a tic-free group and compared on clinical variables with t tests or χ² tests. Linear mixed-model analyses were used to compare the 2-year course between the groups, with the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) as primary outcome measure. Data were collected from 2005 to 2007 and from 2007 to 2009. Compared to patients with tic-free OCD, those with tic-related OCD reported earlier disease onset (P = .009) and more symmetry/ordering symptoms (P = .002). Overall symptom severity was similar in both groups. Patients with tic-related OCD reported increased traits of attention-deficit hyperactivity (P < .001) and autism (P = .005) compared to the tic-free OCD group. Clinical improvement at 2-year follow-up (mean = 5.3-point decrease on the Y-BOCS, P < .001, 95% CI = 4.3 to 6.3) was not significantly moderated by tic status (P = .24). This remained unchanged after correcting for baseline differences. Tics do not critically affect the 2-year course of adult OCD, but tic-related OCD shows differences from tic-free OCD, such as early onset and increased autism and ADHD traits, that may indicate a neurodevelopmental subtype. © Copyright 2016 Physicians Postgraduate Press, Inc.

Fuzzyics =CATEGORYICS =PRAGMATYICS (``Son of ``TRIZ''')/CATEGORY-SEMANTICS Cognition (fcp/csc) of Plato-Aristotle ``SQUARE-of-OPPOSITION''(SoO): Linguistics: Antonyms VS ``SYNONYMS'' VS Analogy/ Metaphor: Coarsest-Possible Topology: Shocks/High-Pressures Applications

NASA Astrophysics Data System (ADS)

Siegel, Edward Plato Aristotle Archimedes Carl-Ludwig; Young, Frederic; Lewis, Thomas

2013-06-01

Siegel[MRS Fall-Mtgs,:Symp.Fractals(89)-5-papers!!!;Symp.Scaling(90)] FCP/CSC {aka SPD}(Tic-Tac-Toe-Matrix/Tabular List-Format) ``COMMON-FUNCTIONING-PRINCIPLE'' DI/TRI-CHOTOMY GENERIC ``INEVITABILITY_-WEB'' PURPOSEFUL PARSIMONY-of-DI/TRI-CHOTOMY STRATEGY REdiscovery of SoO automatically/optimality is in NON-list-format/matrix: DIMENSIONALITY-DOMINATION -INEVIT-ABILITY ROOT-CAUSE(RC) ULTIMATE-ORIGIN(UO): (level-0.-logic) DIMENSIONALITY (level-0. logic): [dst = ODD-Z] <->{Dst=FRACTAL-UNcertainty FLUCTUATIONS} <->(dst = EVEN-Z): CAUSES: (level- I.-logic): EXTENT/SCALE/RADIUS: (relative)-[LOCALITY] <-> (relative)-(...GLOBALITY...) & (level-II.-logic): POWER-SPECTRUM{noise ≅generalized-susceptibility}: [``l''/ω0-White] <->(...-``l''/ω 1 . 000 . . . - HYPERBOLICITY...) & (level-III.-logic) CRITICAL-EXPONENT:n =0 <->n = 1.000... ; BUT ALL 3 ALSO CAUSED BY ANOTHER INdependent RCUO (level-IV.-logic):

Toe-to-hand transfer in symbrachydactyly.

PubMed

Richardson, Philip W F; Johnstone, Bruce R; Coombs, Christopher J

2004-07-01

Symbrachydactyly, or central atypical cleft, is classified as a failure of formation. For the adactylous or monodactylous forms, free toe transfer is the treatment of choice. We present 18 free toe transfers in 13 patients for symbrachydactyly. Despite abnormal anatomy, the functional building blocks have always been available and transfer technically possible. The result has been improved function and high levels of parental satisfaction.

TAMPA ASTHMATIC CHILDREN'S STUDY (TACS)

EPA Science Inventory

The Tampa Asthmatic Children's Study (TACS) was a pilot research study to assess methodologies and research instruments needed for including asthma as a health outcome in the National Children's Study (NCS). This was one of a series of pilot studies focusing on (a) simple, cos...

[Facial tics and spasms].

PubMed

Potgieser, Adriaan R E; van Dijk, J Marc C; Elting, Jan Willem J; de Koning-Tijssen, Marina A J

2014-01-01

Facial tics and spasms are socially incapacitating, but effective treatment is often available. The clinical picture is sufficient for distinguishing between the different diseases that cause this affliction.We describe three cases of patients with facial tics or spasms: one case of tics, which are familiar to many physicians; one case of blepharospasms; and one case of hemifacial spasms. We discuss the differential diagnosis and the treatment possibilities for facial tics and spasms. Early diagnosis and treatment is important, because of the associated social incapacitation. Botulin toxin should be considered as a treatment option for facial tics and a curative neurosurgical intervention should be considered for hemifacial spasms.

The management of tics.

PubMed

Shprecher, David; Kurlan, Roger

2009-01-15

A tic is a stereotyped repetitive involuntary movement or sound, frequently preceded by premonitory sensations or urges. Most tic disorders are genetic or idiopathic in nature, possibly due to a developmental failure of inhibitory function within frontal-subcortical circuits modulating volitional movements. Currently available oral medications can reduce the severity of tics, but rarely eliminate them. Botulinum toxin injections can be effective if there are a few particularly disabling motor tics. Deep brain stimulation has been reported to be an effective treatment for the most severe cases, but remains unproven. A comprehensive evaluation accounting for secondary causes, psychosocial factors, and comorbid neuropsychiatric conditions is essential to successful treatment of tic disorders.

Nailfold Capillaroscopy of Fingers and Toes - Variations of Normal.

PubMed

Lambova, Sevdalina Nikolova; Muller-Ladner, Ulf

2018-04-20

Nailfold capillaroscopy is the only method for morphological assessment of nutritive capillaries. The literature data about capillaroscopic findings in healthy individuals are scarce. To evaluate and compare the capillaroscopic findings of fingers and toes in healthy subjects. 22 healthy individuals were included in the study. Capillaroscopic examination was performed with videocapillaroscope Videocap 3.0 (DS Medica). Exclusion criteria were as follows: history of vasospasm, presence of accompanying diseases, taking any medications, arterial hypertension in first degree relatives, overweight or obesity (body mass index > 25kg/m2) and presence of chronic arterial or venous insufficiency. Poor visibility of nailfold capillaries was found significantly more frequently in the toes (22.7%, 5/22) as compared with fingers (0/22). Slight irregularities in capillary distribution and orientation to their parallel axis were significantly more common in the toes (31.8%, 7/22) as compared with fingers (9%, 2/22), (p<0.05). The mean diameter of the arterial (0.012±0.002mm) and the venous limb (0.017±0.002mm) of the toes did not differ significantly as compared to the respective parameters in the fingers (0.013±0.002mm for the arterial limb, p=0.46 and 0.018±0.002mm for the venous limb, p=0.25). The mean capillary density also did not differ significantly in the fingers and toes. The mean capillary length of the toes (0.165±0.096mm) was shorter as compared with hands (0.220±0.079mm), but the difference was not statistically significant (p=0.37). Presence of tortuous capillaries (>10%) was found significantly more often in the toes (12/22) as compared with fingers (6/22, χ2=6.769, p<0.05). Short capillary loops (length<100µm) were observed significantly more often in the toes (11/22 - toes, 1/22 - fingers, χ2=14.666, p<0.05). Capillaroscopic examination of the toes shows some differences as compared to those of the fingers such as greater number of cases with poor

[Psychogenic tics: clinical characteristics and prevalence].

PubMed

Janik, Piotr; Milanowski, Lukasz; Szejko, Natalia

2014-01-01

Clinical characteristics and the prevalence of psychogenic tics (PT) METHODS: 268 consecutively examined patients aged 4 to 54 years (221 men, 47 females; 134 children, 134 adults) with tic phenotype: Gilles de la Tourette syndrome (GTS, n = 255), chronic motor tics (n = 6), chronic vocal tics (n= 1), transient tics (n = 1), tics unclassified (n = 2), PT (n= 5) were analyzed. The diagnosis of tic disorders was made on the DSM-IV-TR criteria and mental disorders by psychiatrists. PT were found in 5 patients (1.9%), aged 17 to 51 years, four men and one woman. The phenotype included vocalizations and complex movements. In none of the patients simple motor facial tics, inability to tic suppress, unchanging clinical pattern, peak severity from the beginning of the disease, lack of concern about the disease were present. The absence of premonitory urges, regression in unexpected positions, and the presence of atypical for GTS mental disorders were found in two persons. PT occurred in three persons in whom organic tics were present in childhood. Pharmacological treatment and psychotherapy were unsuccessful. In two persons spontaneous resolution occurred, in two patients the tics persist, in one person the course of PT is unknown. PT are rare and may occur in patients with organic tics. The most typical features of PT are: early onset in adulthood, lack of simple motor tics, inability to tic suppress. The diagnosis is established if a few atypical symptoms for organic tics occur.

The Management of Tics

PubMed Central

Shprecher, David; Kurlan, Roger

2009-01-01

A tic is a stereotyped repetitive involuntary movement or sound, frequently preceded by premonitory sensations or urges. Most tic disorders are genetic or idiopathic in nature, possibly due to a developmental failure of inhibitory function within frontal-subcortical circuits modulating volitional movements. Currently available oral medications can reduce the severity of tics, but rarely eliminate them. Botulinum toxin injections can be effective if there are a few particularly disabling motor tics. Deep brain stimulation has been reported to be an effective treatment for the most severe cases, but remains unproven. A comprehensive evaluation accounting for secondary causes, psychosocial factors, and comorbid neuropsychiatric conditions is essential to successful treatment of tic disorders. PMID:19170198

Tic Frequency Decreases during Short-term Psychosocial Stress - An Experimental Study on Children with Tic Disorders.

PubMed

Buse, Judith; Enghardt, Stephanie; Kirschbaum, Clemens; Ehrlich, Stefan; Roessner, Veit

2016-01-01

It has been suggested that psychosocial stress influences situational fluctuations of tic frequency. However, evidence from experimental studies is lacking. The current study investigated the effects of the Trier Social Stress Test (TSST-C) on tic frequency in 31 children and adolescents with tic disorders. A relaxation and a concentration situation served as control conditions. Patients were asked either to suppress their tics or to "tic freely." Physiological measures of stress were measured throughout the experiment. The TSST-C elicited a clear stress response with elevated levels of saliva cortisol, increased heart rate, and a larger number of skin conductance responses. During relaxation and concentration, the instruction to suppress tics reduced the number of tics, whereas during stress, the number of tics was low, regardless of the given instruction. Our study suggests that the stress might result in a situational decrease of tic frequency.

Group behavioral therapy for adolescents with tic-related and non-tic-related obsessive-compulsive disorder.

PubMed

Himle, Joseph A; Fischer, Daniel J; Van Etten, Michelle L; Janeck, Amy S; Hanna, Gregory L

2003-01-01

Prior research supports the distinction between tic-related and non-tic-related obsessive-compulsive disorder (OCD) based on phenomenologic, etiologic, and neurobehavioral data. The present study examines whether response to psychosocial treatment differs in adolescents, depending on the presence of comorbid tics. Nineteen adolescents, 12-17 years of age, participated in 7-week, uncontrolled trial of group cognitive-behavioral treatment (CBT) for OCD. Eight of the patients had tic-related and eleven had non-tic-related OCD. The group CBT program included psycho-education, exposure and response prevention, cognitive strategies, and family involvement. Significant improvement was observed for all subjects on the Yale-Brown Obsessive Compulsive Scale ratings of obsessions, compulsions, and total OCD symptoms. Outcomes were similar for subjects with tic-related and non-tic-related OCD. These preliminary results suggest that the presence of comorbid tic disorders may not attenuate response to behavioral group treatment among adolescents. Copyright 2003 Wiley-Liss, Inc.

Information and Library Programs at the Technology Application Center (TAC).

ERIC Educational Resources Information Center

Burch, Eugene

The Technology Application Center (TAC) at the University of New Mexico is one of six National Aeronautics and Space Administration (NASA) regional dissemination centers originally established to disseminate NASA technology to private industry on a regional basis. A fee is charged for TAC's services so it has been market oriented and has sought to…

Hypoxic ventilatory response in Tac1-/- neonatal mice following exposure to opioids.

PubMed

Berner, J; Shvarev, Y; Zimmer, A; Wickstrom, R

2012-12-01

Morphine is the dominating analgetic drug used in neonates, but opioid-induced respiratory depression limits its therapeutic use. In this study, we examined acute morphine effects on respiration during intermittent hypoxia in newborn Tac1 gene knockout mice (Tac1-/-) lacking substance P and neurokinin A. In vivo, plethysmography revealed a blunted hypoxic ventilatory response (HVR) in Tac1-/- mice. Morphine (10 mg/kg) depressed the HVR in wild-type animals through an effect on respiratory frequency, whereas it increased tidal volumes in Tac1-/- during hypoxia, resulting in increased minute ventilation. Apneas were reduced during the first hypoxic episode in both morphine-exposed groups, but were restored subsequently in Tac1-/- mice. Morphine did not affect ventilation or apnea prevalence during baseline conditions. In vitro, morphine (50 nM) had no impact on anoxic response of brain stem preparations of either strain. In contrast, it suppressed the inspiratory rhythm during normoxia and potentiated development of posthypoxic neuronal arrest, especially in Tac1-/-. Thus this phenotype has a higher sensitivity to the depressive effects of morphine on inspiratory rhythm generation, but morphine does not modify the reactivity to oxygen deprivation. In conclusion, although Tac1-/- mice are similar to wild-type animals during normoxia, they differed by displaying a reversed pattern with an improved HVR during intermittent hypoxia both in vivo and in vitro. These data suggest that opioids and the substance P-ergic system interact in the HVR, and that reducing the activity in the tachykinin system may alter the respiratory effects of opioid treatment in newborns.

Pahoehoe toe dimensions, morphology, and branching relationships at Mauna Ulu, Kilauea Volcano, Hawai'i

NASA Astrophysics Data System (ADS)

Crown, David A.; Baloga, Stephen M.

Pahoehoe toe dimensions, morphology, and branching relationships were analyzed in flows emplaced during 1972 at Mauna Ulu, a satellitic shield on the east rift zone of Kilauea Volcano, Hawai'i. In order to characterize regions within flow fields dominated by networks of pahoehoe toes, measurements of toe length, width, thickness, and orientation were completed for 445 toes at 13 sites. Variations in site characteristics, including slope, substrate, and position in the flow field allow an evaluation of the effects of such parameters on toe dimensions. Toe surface morphology (ropy or smooth), local flow lobe position (interior or margin), and connective relationships between toes were documented in the form of detailed toe maps. These maps show the number of branches connecting a given toe to other toes in its local pahoehoe network and illustrate branching patterns. Statistical analyses of toe dimensions and comparisons of pahoehoe toe study sites and sub-populations combined with field observations, evaluation of toe maps, and qualitative examination of toe dimension size distributions show the following: (a) Although there are significant variations at a given site, toes typically have mean lengths (101cm) greater than mean widths (74cm) and mean widths greater than mean thicknesses (19cm) sites that have mean widths greater than mean lengths are those with lower slopes. (b) Where significant site-to-site variations in mean values of a given toe dimension were apparent, these differences could not be directly related to site characteristics. (c) Ropy toes have significantly larger mean values of length, width, and number of branches than smooth toes, and toes with three or more branches have greater lengths, widths, and thicknesses than toes with two or fewer branches, suggesting concentration of flow in these toe types. (d) The skewness of all size distributions of toe length and width to larger values suggests that toes are transitional to larger sheets and

Durability, Negative Impact, and Neuropsychological Predictors of Tic Suppression in Children with Chronic Tic Disorder

ERIC Educational Resources Information Center

Woods, Douglas W.; Himle, Michael B.; Miltenberger, Raymond G.; Carr, James E.; Osmon, David C.; Karsten, Amanda M.; Jostad, Candice; Bosch, Amanda

2008-01-01

Chronic tic disorders are characterized by involuntary motor and vocal tics, which are influenced by contextual factors. Recent research has shown that (a) children can suppress tics for brief periods of time, (b) suppression is enhanced when programmed reinforcement is provided for tic-free intervals, and (c) short periods of suppression do not…

Tic disorders.

PubMed

Martino, Davide; Mink, Jonathan W

2013-10-01

Primary tic disorders are complex, multifactorial disorders in which tics are accompanied by other sensory features and an array of comorbid behavioral disorders. Secondary tics are proportionally much less frequent, but their etiology is diverse. This review aims to guide clinicians in the recognition of the phenomenology, pathophysiology, and treatment of these disorders. Advances include greater phenomenologic insights, particularly of nonmotor (sensory) features; increased knowledge of disease mechanisms, particularly coming from neuropsychological, functional imaging, pathologic, and animal model studies; growing evidence on the efficacy of alpha-2 agonists and the newer generation of dopamine-modulating agents; and recent strides in the evaluation of cognitive-behavioral therapy and deep brain stimulation surgery. The correct diagnostic approach to tic disorders requires accurate historical gathering, a thorough neurologic examination, and detailed definition of the patient's psychopathologic profile. Treatment should always begin with individualized psychoeducational strategies. Although pharmacologic treatments remain beneficial for most patients, cognitive-behavioral treatments have thus far shown promising efficacy. Deep brain stimulation surgery should still be limited to adult patients refractory to pharmacotherapy and cognitive-behavioral therapy.

Late-Onset Psychogenic Chronic Phonic-Tics.

PubMed

Vale, Thiago Cardoso; Pedroso, José Luiz; Knobel, Marcos; Knobel, Elias

2016-01-01

Tics beginning in late adulthood often have an identifiable etiology. Psychogenic tics with onset around 60 years of age are rarely described in the literature. A 67-year-old female had experienced phonic tics for 8 years. Episodes occurred without premonitory sensations and precipitant factors, and she could not suppress them. She had no history of childhood tic disorder, and secondary causes of tics were excluded. She was diagnosed with psychogenic tics and treated with quetiapine with mild improvement. When physicians are faced with no identifiable cause of tics combined with certain clinical clues, a psychogenic disorder must be suspected.

[Diagnosis and treatment of tics].

PubMed

Topka, H

2007-05-21

Tics are repetitive and sudden purposeless movements. Phenomenologically tics are differentiated as simple or complex, motor or vocal. Transient forms, which last less than 1 year, occur frequently in child hood. For Tourette syndrome, multiple simple and complex motor and vocal tics are present for more than one year. Frequently, additional symptoms of an obsessive-compulsive disorder or an attention deficit hyperactivity disorder are present. There is no therapy for the cause of tics. For minor symptoms or if a transient tic disorder is suspected, the use of medications should be avoided. Instead the patient and if necessary, the parents should be informed in detail and given advice. Particularly for children, it is important to exclude antiepileptic drugs as the cause of tics. For chronic tics and for pronounced symptoms, drug therapy with neuroleptic drugs or clonidine is a possibility. However, the efficacy of these substances is limited.

Living with tics: reduced impairment and improved quality of life for youth with chronic tic disorders.

PubMed

McGuire, Joseph F; Arnold, Elysse; Park, Jennifer M; Nadeau, Joshua M; Lewin, Adam B; Murphy, Tanya K; Storch, Eric A

2015-02-28

Pharmacological and behavioral interventions have focused on reducing tic severity to alleviate tic-related impairment for youth with chronic tic disorders (CTDs), with no existing intervention focused on the adverse psychosocial consequences of tics. This study examined the preliminary efficacy of a modularized cognitive behavioral intervention ("Living with Tics", LWT) in reducing tic-related impairment and improving quality of life relative to a waitlist control of equal duration. Twenty-four youth (ages 7-17 years) with Tourette Disorder or Chronic Motor Tic Disorder and psychosocial impairment participated. A treatment-blind evaluator conducted all pre- and post-treatment clinician-rated measures. Youth were randomly assigned to receive the LWT intervention (n=12) or a 10-week waitlist (n=12). The LWT intervention consisted of up to 10 weekly sessions targeted at reducing tic-related impairment and developing skills to manage psychosocial consequences of tics. Youth in the LWT condition experienced significantly reduced clinician-rated tic-impairment, and improved child-rated quality of life. Ten youth (83%) in the LWT group were classified as treatment responders compared to four youth in the waitlist condition (33%). Treatment gains were maintained at one-month follow-up. Findings provide preliminary data that the LWT intervention reduces tic-related impairment and improves quality of life for youth with CTDs. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Living with Tics: Reduced Impairment and Improved Quality of Life for Youth with Chronic Tic Disorders

PubMed Central

McGuire, Joseph F.; Arnold, Elysse; Park, Jennifer M.; Nadeau, Joshua M.; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

2014-01-01

Pharmacological and behavioral interventions have focused on reducing tic severity to alleviate tic-related impairment for youth with chronic tic disorders (CTDs), with no existing intervention focused on the adverse psychosocial consequences of tics. This study examined the preliminary efficacy of a modularized cognitive behavioral intervention ("Living with Tics", LWT) in reducing tic-related impairment and improving quality of life relative to a waitlist control of equal duration. Twenty-four youth (ages 7–17 years) with Tourette Disorder or Chronic Motor Tic Disorder and psychosocial impairment participated. A treatment-blind evaluator conducted all pre- and post-treatment clinician-rated measures. Youth were randomly assigned to receive the LWT intervention (n=12) or a 10-week waitlist (n=12). The LWT intervention consisted of up to 10 weekly sessions targeted at reducing tic-related impairment and developing skills to manage psychosocial consequences of tics. Youth in the LWT condition experienced significantly reduced clinician-rated tic-impairment, and improved child-rated quality of life. Ten youth (83%) in the LWT group were classified as treatment responders compared to four youth in the waitlist condition (33%). Treatment gains were maintained at one-month follow-up. Findings provide preliminary data that the LWT intervention reduces tic-related impairment and improves quality of life for youth with CTDs. PMID:25500348

Turf Toe

PubMed Central

McCormick, Jeremy J.; Anderson, Robert B.

2010-01-01

Context: Despite an increasing awareness of turf toe injury, confusion still exists regarding the anatomy, mechanism, diagnosis, and treatment of this hyperextension injury to the hallux metatarsophalangeal (MTP) joint. Evidence Acquisition: This article reviews the anatomy, diagnosis, and treatment algorithm for turf toe injury by reviewing relevant studies and presenting information useful to clinicians, therapists, and athletic trainers. A literature search was performed by a review of PubMed and OVID articles published from 1976 to July 2010. Results: Grade I injury is a sprain or attenuation of the plantar capsular ligamentous complex of the hallux MTP joint; athletes are typically able to return to play as tolerated. Grade II injury is a partial rupture of the plantar soft tissue structures of the hallux MTP joint, typically requiring about 2 weeks to recover. Grade III injury is a complete rupture of the plantar structures of the hallux MTP joint, requiring at least 10 to 16 weeks to recover. Some complete ruptures require surgical repair. Conclusion: With accurate diagnosis, athletes can have an appropriate treatment plan, and their expectations can be tempered to the degree of injury. Careful management may allow successful return to play at a preinjury level of participation. PMID:23015979

[Comorbidity of tics and stuttering].

PubMed

Surushkina, S Yu; Chutko, L S; Aitbekov, K A; Nikishena, I S; Bondarchuk, Yu I

2014-01-01

To determine the clinical presentations of stuttering in children with tics treated with noofen. Authors examined 181 children with tics, aged 7-13. Stuttering was identified in 23.2% of cases. Thirty children with tics and comorbid stuttering received noofen. RESULTS AND СONCLUSION: The prevalence of stuttering in children with tics was significantly higher than in the population. Stuttering was significantly more frequent in children with transient tics than chronic tics. Neurotic stuttering was recorded more frequently. The high efficacy of noofen was shown; the decrease in ticks was obtained in 80% of cases, the reduction of stuttering in 66.7% of cases. The data of clinical, psychological and neurophysiological studies, confirming the improvement of patients after treatment, are presented.

Comparison of Two Alternate Methods for Tracking Toe Clearance

NASA Technical Reports Server (NTRS)

Miller, Christopher A.; Feiveson, Alan H.; Bloomberg, Jacob J.

2007-01-01

Analyses of toe clearance during the swing phase of locomotion has often been utilized in determining a subject s propensity to trip while either walking or stepping over an obstacle. In the literature, toe clearance has been studied using a marker on the superior aspect of the second toe (rtoe), a marker on the lateral aspect of the fifth metatarsal head (mth5), or a virtual marker positioned at the anterior tip of the toe (vtoe). The purpose of this study was to compute toe clearance and associated parameters using a fifth metatarsal marker and a virtual toe marker, and compare the results with those of the standard toe marker. Subjects walked on a motorized treadmill at five different speeds while performing a visual acuity task at two separate target distances (ten 60-second trials). The minimum vertical height (TCl) was determined for each stride, along with its point of occurence in the gait cycle, and the angles of the foot and ankle at that time. A regression analysis was performed on the vtoe and mth5 results versus rtoe individually. For all TCl parameters, the mth5 marker did not correlate well with rtoe; the vtoe marker showed better agreement. Most importantly, the mth5 marker predicted a later occurence of TCl than rtoe and vtoe - thereby missing the most dangerous point in swing phase for a trip. From this analysis, the vtoe marker proved to be a better analog to rtoe than mth5, especially for determining a subject s propensity to trip.

Tic Frequency Decreases during Short-term Psychosocial Stress – An Experimental Study on Children with Tic Disorders

PubMed Central

Buse, Judith; Enghardt, Stephanie; Kirschbaum, Clemens; Ehrlich, Stefan; Roessner, Veit

2016-01-01

It has been suggested that psychosocial stress influences situational fluctuations of tic frequency. However, evidence from experimental studies is lacking. The current study investigated the effects of the Trier Social Stress Test (TSST-C) on tic frequency in 31 children and adolescents with tic disorders. A relaxation and a concentration situation served as control conditions. Patients were asked either to suppress their tics or to “tic freely.” Physiological measures of stress were measured throughout the experiment. The TSST-C elicited a clear stress response with elevated levels of saliva cortisol, increased heart rate, and a larger number of skin conductance responses. During relaxation and concentration, the instruction to suppress tics reduced the number of tics, whereas during stress, the number of tics was low, regardless of the given instruction. Our study suggests that the stress might result in a situational decrease of tic frequency. PMID:27242554

Walking, running and the evolution of short toes in humans.

PubMed

Rolian, Campbell; Lieberman, Daniel E; Hamill, Joseph; Scott, John W; Werbel, William

2009-03-01

The phalangeal portion of the forefoot is extremely short relative to body mass in humans. This derived pedal proportion is thought to have evolved in the context of committed bipedalism, but the benefits of shorter toes for walking and/or running have not been tested previously. Here, we propose a biomechanical model of toe function in bipedal locomotion that suggests that shorter pedal phalanges improve locomotor performance by decreasing digital flexor force production and mechanical work, which might ultimately reduce the metabolic cost of flexor force production during bipedal locomotion. We tested this model using kinematic, force and plantar pressure data collected from a human sample representing normal variation in toe length (N=25). The effect of toe length on peak digital flexor forces, impulses and work outputs was evaluated during barefoot walking and running using partial correlations and multiple regression analysis, controlling for the effects of body mass, whole-foot and phalangeal contact times and toe-out angle. Our results suggest that there is no significant increase in digital flexor output associated with longer toes in walking. In running, however, multiple regression analyses based on the sample suggest that increasing average relative toe length by as little as 20% doubles peak digital flexor impulses and mechanical work, probably also increasing the metabolic cost of generating these forces. The increased mechanical cost associated with long toes in running suggests that modern human forefoot proportions might have been selected for in the context of the evolution of endurance running.

Elastic modulus of tree frog adhesive toe pads.

PubMed

Barnes, W Jon P; Goodwyn, Pablo J Perez; Nokhbatolfoghahai, Mohsen; Gorb, Stanislav N

2011-10-01

Previous work using an atomic force microscope in nanoindenter mode indicated that the outer, 10- to 15-μm thick, keratinised layer of tree frog toe pads has a modulus of elasticity equivalent to silicone rubber (5-15 MPa) (Scholz et al. 2009), but gave no information on the physical properties of deeper structures. In this study, micro-indentation is used to measure the stiffness of whole toe pads of the tree frog, Litoria caerulea. We show here that tree frog toe pads are amongst the softest of biological structures (effective elastic modulus 4-25 kPa), and that they exhibit a gradient of stiffness, being stiffest on the outside. This stiffness gradient results from the presence of a dense network of capillaries lying beneath the pad epidermis, which probably has a shock absorbing function. Additionally, we compare the physical properties (elastic modulus, work of adhesion, pull-off force) of the toe pads of immature and adult frogs.

Serum 25-hyroxyvitamin D levels and tic severity in Chinese children with tic disorders.

PubMed

Li, Hong-Hua; Shan, Ling; Wang, Bing; Du, Lin; Xu, Zhi-Da; Jia, Fei-Yong

2018-05-31

The aim of this study is to evaluate serum 25-hydroxyvitamin D[25(OH)D] levels in children with tic disorders and to explore the relationship between serum 25(OH)D level and tic severity. Children (n = 179, 31 females, 148 males, mean age at diagnosis: 8.0 ± 2.7 years old, age ranged from 3 to 14.5 years old) who were diagnosed with a tic disorder were enrolled as case group, 189 healthy children were recruited as control group. Serum level of 25(OH)D of each child was measured by high performance liquid chromatography and tandem mass spectrometry (HPLC-MS/MS). Yale Global Tic Severity Scale (YGTSS) was used to assess tic severity. Mean serum level of 25(OH)D in the case group was significantly lower than that of the control group. The serum 25(OH)D level was significantly associated with tic severity after adjusting for age and body mass index (BMI). This study identified a high prevalence of vitamin D insufficiency or deficiency in children with tic disorders, and there was a negative correlation between the serum 25(OH)D level and tic severity. In the future, large sample size studies are urgently needed to further clarify this correlation. Copyright © 2018. Published by Elsevier B.V.

Paliperidone-associated motor tics.

PubMed

Hsieh, Ming-Han; Chiu, Nan-Ying

2014-01-01

Paliperidone-associated motor tics. Case report. We report a 30-year-old man with schizophrenia who developed motor tics (eye blinking) after treatment of paliperidone up to 15 mg daily. Tic-like symptoms, from simple eye blinking to complex Tourette-like syndrome, may occur during paliperidone treatment, especially with high dose. Crown Copyright © 2014. Published by Elsevier Inc. All rights reserved.

Feedforward neural control of toe walking in humans.

PubMed

Lorentzen, Jakob; Willerslev-Olsen, Maria; Hüche Larsen, Helle; Svane, Christian; Forman, Christian; Frisk, Rasmus; Farmer, Simon Francis; Kersting, Uwe; Nielsen, Jens Bo

2018-03-23

Activation of ankle muscles at ground contact during toe walking is unaltered when sensory feedback is blocked or the ground is suddenly dropped. Responses in the soleus muscle to transcranial magnetic stimulation, but not peripheral nerve stimulation, are facilitated at ground contact during toe walking. We argue that toe walking is supported by feedforward control at ground contact. Toe walking requires careful control of the ankle muscles in order to absorb the impact of ground contact and maintain a stable position of the joint. The present study aimed to clarify the peripheral and central neural mechanisms involved. Fifteen healthy adults walked on a treadmill (3.0 km h -1 ). Tibialis anterior (TA) and soleus (Sol) EMG, knee and ankle joint angles, and gastrocnemius-soleus muscle fascicle lengths were recorded. Peripheral and central contributions to the EMG activity were assessed by afferent blockade, H-reflex testing, transcranial magnetic brain stimulation (TMS) and sudden unloading of the planter flexor muscle-tendon complex. Sol EMG activity started prior to ground contact and remained high throughout stance. TA EMG activity, which is normally seen around ground contact during heel strike walking, was absent. Although stretch of the Achilles tendon-muscle complex was observed after ground contact, this was not associated with lengthening of the ankle plantar flexor muscle fascicles. Sol EMG around ground contact was not affected by ischaemic blockade of large-diameter sensory afferents, or the sudden removal of ground support shortly after toe contact. Soleus motor-evoked potentials elicited by TMS were facilitated immediately after ground contact, whereas Sol H-reflexes were not. These findings indicate that at the crucial time of ankle stabilization following ground contact, toe walking is governed by centrally mediated motor drive rather than sensory driven reflex mechanisms. These findings have implications for our understanding of the control of

McArdle's disease: A differential diagnosis of idiopathic toe walking.

PubMed

Pomarino, David; Martin, Stephan; Pomarino, Andrea; Morigeau, Stefanie; Biskup, Saskia

2018-06-01

Idiopathic toe walking (ITW) is a pathological gait pattern in which children walk on their tip toes with no orthopedic or neurological reason. Physiological characteristics of the gastrocnemius muscles, the Achilles tendon, and the foot of toe walkers differ from subjects with a plantigrade walking pattern. McArdle's disease is characterized by the inability to break down muscle glycogen. It is an autosomal-recessive condition, characterized by low exercise tolerance, muscular atrophy at the shoulder girdle, episodes of myoglobinuria after vigorous physical activities and the occurrence of the second wind phenomenon. The aim of this review is to present the case studies of two subjects who were originally diagnosed as idiopathic toe walkers, but were then found to have McArdle's disease. This review will describe some physical characteristics that distinguish McArdle´s disease from Idiopathic toe walkers.

Gold rush - A swarm dynamics in games

NASA Astrophysics Data System (ADS)

Zelinka, Ivan; Bukacek, Michal

2017-07-01

This paper is focused on swarm intelligence techniques and its practical use in computer games. The aim is to show how a swarm dynamics can be generated by multiplayer game, then recorded, analyzed and eventually controlled. In this paper we also discuss possibility to use swarm intelligence instead of game players. Based on our previous experiments two games, using swarm algorithms are mentioned briefly here. The first one is strategy game StarCraft: Brood War, and TicTacToe in which SOMA algorithm has also take a role of player against human player. Open research reported here has shown potential benefit of swarm computation in the field of strategy games and players strategy based on swarm behavior record and analysis. We propose new game called Gold Rush as an experimental environment for human or artificial swarm behavior and consequent analysis.

IVA the robot: Design guidelines and lessons learned from the first space station laboratory manipulation system

NASA Technical Reports Server (NTRS)

Konkel, Carl R.; Powers, Allen K.; Dewitt, J. Russell

1991-01-01

The first interactive Space Station Freedom (SSF) lab robot exhibit was installed at the Space and Rocket Center in Huntsville, AL, and has been running daily since. IntraVehicular Activity (IVA) the robot is mounted in a full scale U.S. Lab (USL) mockup to educate the public on possible automation and robotic applications aboard the SSF. Responding to audio and video instructions at the Command Console, exhibit patrons may prompt IVA to perform a housekeeping task or give a speaking tour of the module. Other exemplary space station tasks are simulated and the public can even challenge IVA to a game of tic tac toe. In anticipation of such a system being built for the Space Station, a discussion is provided of the approach taken, along with suggestions for applicability to the Space Station Environment.

The TacTip Family: Soft Optical Tactile Sensors with 3D-Printed Biomimetic Morphologies

PubMed Central

Pestell, Nicholas; Cramphorn, Luke; Winstone, Benjamin; Giannaccini, Maria Elena; Rossiter, Jonathan; Lepora, Nathan F.

2018-01-01

Abstract Tactile sensing is an essential component in human–robot interaction and object manipulation. Soft sensors allow for safe interaction and improved gripping performance. Here we present the TacTip family of sensors: a range of soft optical tactile sensors with various morphologies fabricated through dual-material 3D printing. All of these sensors are inspired by the same biomimetic design principle: transducing deformation of the sensing surface via movement of pins analogous to the function of intermediate ridges within the human fingertip. The performance of the TacTip, TacTip-GR2, TacTip-M2, and TacCylinder sensors is here evaluated and shown to attain submillimeter accuracy on a rolling cylinder task, representing greater than 10-fold super-resolved acuity. A version of the TacTip sensor has also been open-sourced, enabling other laboratories to adopt it as a platform for tactile sensing and manipulation research. These sensors are suitable for real-world applications in tactile perception, exploration, and manipulation, and will enable further research and innovation in the field of soft tactile sensing. PMID:29297773

The TacTip Family: Soft Optical Tactile Sensors with 3D-Printed Biomimetic Morphologies.

PubMed

Ward-Cherrier, Benjamin; Pestell, Nicholas; Cramphorn, Luke; Winstone, Benjamin; Giannaccini, Maria Elena; Rossiter, Jonathan; Lepora, Nathan F

2018-04-01

Tactile sensing is an essential component in human-robot interaction and object manipulation. Soft sensors allow for safe interaction and improved gripping performance. Here we present the TacTip family of sensors: a range of soft optical tactile sensors with various morphologies fabricated through dual-material 3D printing. All of these sensors are inspired by the same biomimetic design principle: transducing deformation of the sensing surface via movement of pins analogous to the function of intermediate ridges within the human fingertip. The performance of the TacTip, TacTip-GR2, TacTip-M2, and TacCylinder sensors is here evaluated and shown to attain submillimeter accuracy on a rolling cylinder task, representing greater than 10-fold super-resolved acuity. A version of the TacTip sensor has also been open-sourced, enabling other laboratories to adopt it as a platform for tactile sensing and manipulation research. These sensors are suitable for real-world applications in tactile perception, exploration, and manipulation, and will enable further research and innovation in the field of soft tactile sensing.

Tics and tourette syndrome.

PubMed

Ganos, Christos; Martino, Davide

2015-02-01

Gilles de la Tourette syndrome is a common neuropsychiatric disorder spectrum with tics as the defining feature. Comorbidities such as attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, and autism spectrum disorder often complicate clinical presentation. Their recognition is paramount for the introduction of efficient treatment strategies to promote healthy development and good quality of life. Here, knowledge on the movement disorder of tics, the spectrum of associated comorbidities, and the list of differential diagnoses of tic disorders are summarized. Also, an account of the prevailing pathophysiologic models of tic generation is provided, and a concise update on contemporary treatment strategies is presented. Copyright © 2015 Elsevier Inc. All rights reserved.

A positive diagnosis of functional (psychogenic) tics.

PubMed

Demartini, B; Ricciardi, L; Parees, I; Ganos, C; Bhatia, K P; Edwards, M J

2015-03-01

Functional tics, also called psychogenic tics or pseudo-tics, are difficult to diagnose because of the lack of diagnostic criteria and their clinical similarities to organic tics. The aim of the present study was to report a case series of patients with documented functional tics and to describe their clinical characteristics, risk factors and psychiatric comorbidity. Also clinical tips are suggested which might help the differential diagnosis in clinical practice. Eleven patients (mean age at onset 37.2, SD 13.5; three females) were included with a documented or clinically established diagnosis of functional tics, according to consultant neurologists who have specific expertise in functional movement disorders or in tic disorders. Adult onset, absent family history of tics, inability to suppress the movements, lack of premonitory sensations, absence of pali-, echo- and copro-phenomena, presence of blocking tics, the lack of the typical rostrocaudal tic distribution and the coexistence of other functional movement disorders were common in our patients. Our data suggest that functional tics can be differentiated from organic tics on clinical grounds, although it is also accepted that this distinction can be difficult in certain cases. Clinical clues from history and examination described here might help to identify patients with functional tics. © 2014 EAN.

Acute Worsening of Tics on Varenicline.

PubMed

Mittal, Shivam Om; Klassen, Bryan T; Hassan, Anhar; Bower, James H; Coon, Elizabeth A

The aim of this study was to report worsening of Tourette syndrome (TS) in 2 patients treated with varenicline. Abnormal dopaminergic signaling is likely involved in the pathophysiology of TS. Varenicline is a partial α4β2 nicotinic acetylcholine agonist that enhances dopamine release. Therefore, the use of varenicline may influence tics in patients with TS. We analyzed and described 2 case studies on patients with significant worsening of tics after treatment with varenicline. Patient 1 had motor tics in childhood, which completely resolved by the age of 20 years. At the age of 25 years, he started varenicline and stopped smoking. Within 2 weeks, he developed motor followed by vocal tics that persisted despite stopping varenicline and restarting smoking. The tics were complex, medically refractory, and caused severe disability at work and school (Yale Global Tic Severity Scale score, 86). Patient 2 developed motor and vocal tics in adolescence that persisted into her 20s and caused significant disability in association with psychiatric comorbidities. At the age of 31 years, she started varenicline to quit smoking, which led to a marked increase in tic frequency and severity. Varenicline was discontinued after 3 weeks with improvement to baseline tic severity (Yale Global Tic Severity Scale score, 94). Ultimately, both patients successfully underwent deep brain stimulation to bilateral centromedian/parafascicular complex thalamic nuclei for medically refractory TS. We report 2 patients with motor and/or vocal tics that had severe worsening of tics after varenicline use. This may be due to varenicline-induced increased striatal dopamine in conjunction with nicotine cessation, influencing dopamine receptor sensitivity in TS. Providers should be cautious in prescribing varenicline to patients with TS.

Inhibition of motor cortex excitability with 15Hz transcranial alternating current stimulation (tACS).

PubMed

Zaghi, Soroush; de Freitas Rezende, Larissa; de Oliveira, Laís Machado; El-Nazer, Rasheda; Menning, Sanne; Tadini, Laura; Fregni, Felipe

2010-08-02

There remains a lack of solid evidence showing whether transcranial stimulation with weak alternating current (transcranial alternating current stimulation, tACS) can in fact induce significant neurophysiological effects. Previously, a study in which tACS was applied for 2 and 5min with current density=0.16-0.25A/m(2) was unable to show robust effects on cortical excitability. Here we applied tACS at a significantly higher current density (0.80A/m(2)) for a considerably longer duration (20min) and were indeed able to demonstrate measurable changes to cortical excitability. Our results show that active 15Hz tACS of the motor cortex (electrodes placed at C3 and C4) significantly diminished the amplitude of motor evoked potentials and decreased intracortical facilitation (ICF) as compared to baseline and sham stimulation. In addition, we show that our method of sham tACS is a reliable control condition. These results support the notion that AC stimulation with weak currents can induce significant changes in brain excitability; in this case, 15Hz tACS led to a pattern of inhibition of cortical excitability. We propose that tACS may have a dampening effect on cortical networks and perhaps interfere with the temporal and spatial summation of weak subthreshold electric potentials. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

Mediator Tail Module Is Required for Tac1-Activated CDR1 Expression and Azole Resistance in Candida albicans.

PubMed

Liu, Zhongle; Myers, Lawrence C

2017-11-01

The human fungal pathogen Candida albicans develops drug resistance after long-term exposure to azole drugs in the treatment of chronic candidiasis. Gain-of-function (GOF) mutations in the transcription factor Tac1 and the consequent expression of its targets, drug efflux pumps Cdr1 and Cdr2, are a common mechanism by which C. albicans acquires fluconazole resistance. The mechanism by which GOF mutations hyperactivate Tac1 is currently unknown. Here, we define a transcriptional activation domain (TAD) at the C terminus of Tac1. GOF mutations within the Tac1 TAD, outside the context of full-length Tac1, generally do not enhance its absolute potential as a transcriptional activator. Negative regulation of the Tac1 TAD by the Tac1 middle region is necessary for the activating effect of GOF mutations or fluphenazine to be realized. We have found that full-length Tac1, when hyperactivated by xenobiotics or GOF mutations, facilitates the recruitment of the Mediator coactivator complex to the CDR1 promoter. Azole resistance and the activation of Tac1 target genes, such as CDR1 , are dependent on the Tac1 TAD and subunits of the Mediator tail module. The dependence of different Tac1 target promoters on the Mediator tail module, however, varies widely. Lastly, we show that hyperactivation of Tac1 is correlated with its Mediator-dependent phosphorylation, a potentially useful biomarker for Tac1 hyperactivation. The role of Mediator in events downstream of Tac1 hyperactivation in fluconazole-resistant clinical isolates is complex and provides opportunities and challenges for therapeutic intervention. Copyright © 2017 American Society for Microbiology.

Long-term donor site morbidity after free nonvascularized toe phalangeal transfer.

PubMed

Garagnani, Lorenzo; Gibson, Marc; Smith, Paul J; Smith, Gillian D

2012-04-01

Free nonvascularized toe phalangeal transfer is an established surgical option for the reconstruction of hypoplastic digits. This study assessed long-term morbidity in the feet using this technique. We reviewed 40 children treated between 1991 and 2007 by free nonvascularized toe phalangeal transfer. The diagnosis was digital hypoplasia resulting from symbrachydactyly in 33 cases, constriction ring syndrome in 3 cases, thumb hypoplasia in 3 cases, and perinatal subclavian venous thrombosis in 1 case. The patients were followed up after surgery for a mean of 10 years (range, 3-19 y). The Oxford Ankle Foot Questionnaire was administered to patients and families to assess patient symptoms and patient and parental satisfaction. We assessed toe length ratio, the presence of visible deformity, and distal hypoplasia of the donor toes clinically and radiographically. Emotional problems related to foot appearance were common. We also found functional problems with footwear in some patients. All patients had floppy unstable toes with visible deformity. Increasing foot deformity was seen with growth, which led to deterioration in foot aesthetics, particularly where multiple donor toes had been harvested. We identified distal and middle phalangeal and metatarsal hypoplasia in the donor toes. Donor site morbidity for free toe phalangeal transfer is greater than previously documented. This should be considered during surgical decision making for reconstruction of hypoplastic digits. Preoperative counseling should include discussion regarding possible consequences of phalangeal harvest on donor toes and options for donor site reconstruction. Long-term follow-up of the donor site is essential to accurately assess results. Therapeutic III. Copyright © 2012 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Psychometric Properties of a Self-Report Instrument for the Assessment of Tic Severity in Adults With Tic Disorders.

PubMed

Abramovitch, Amitai; Reese, Hannah; Woods, Douglas W; Peterson, Alan; Deckersbach, Thilo; Piacentini, John; Scahill, Lawrence; Wilhelm, Sabine

2015-11-01

The gold-standard measure of tic severity in tic disorders (TD), the Yale Global Tic Severity Scale (YGTSS), is a semistructured clinician-administered interview that can be time consuming and requires highly trained interviewers. Moreover, the YGTSS does not provide information regarding frequency and intensity of specific tics because all motor and all vocal tics are rated as a group. The aim of the present study is to describe and test the Adult Tic Questionnaire (ATQ), a measure for the assessment of tic severity in adults, and to report its preliminary psychometric properties. The ATQ is a brief self-report questionnaire that provides information regarding frequency, intensity, and severity of 27 specific tics. In addition, the ATQ produces total frequency, intensity, and severity scores for vocal and motor tics, as well as a global total tic severity score. Results showed that the ATQ demonstrated very good internal consistency and temporal stability. The total, vocal, and motor tic severity scales of the ATQ showed strong correlation with corresponding subscales of the YGTSS, indicating strong convergent validity. Weak correlations with measures of severity of obsessive-compulsive disorder and attention deficit/hyperactivity disorder, indicated strong discriminant validity. The ATQ, a promising measure for the assessment of tic severity in adults with TD, may be a valuable supplement to the current recommended assessment battery for TD. Furthermore, the ATQ enables clinicians and researchers to track changes in the frequency and intensity of specific tics, which is important given their complex and dynamic nature. Copyright © 2015. Published by Elsevier Ltd.

Psychometric Properties of a Self-Report Instrument for the Assessment of Tic Severity in Adults with Tic Disorders

PubMed Central

Abramovitch, Amitai; Reese, Hannah; Woods, Douglas W.; Peterson, Alan; Deckersbach, Thilo; Piacentini, John; Scahill, Lawrence; Wilhelm, Sabine

2017-01-01

The gold-standard measure of tic severity in Tic Disorders (TD), the Yale Global Tic Severity Scale (YGTSS), is a semi-structured clinician-administered interview that can be time consuming and requires highly trained interviewers. Moreover, the YGTSS does not provide information regarding frequency and intensity of specific tics as all motor, and all vocal tics are rated as a group. The aim of the present study is to describe and test the Adult Tic Questionnaire (ATQ), a measure for the assessment of tic severity in adults, and to report its preliminary psychometric properties. The ATQ is a brief self-report questionnaire that provides information regarding frequency, intensity, and severity of 27 specific tics. In addition, the ATQ produces total frequency, intensity, and severity scores for vocal, and motor tics, as well as a global total tic severity score. Results showed that the ATQ demonstrated very good internal consistency and temporal stability. The total, vocal, and motor tic severity scales of the ATQ showed strong correlation with corresponding subscales of the YGTSS, indicating strong convergent validity. Weak correlations with measures of severity of obsessive-compulsive disorder and attention deficit/hyperactivity disorder, indicated strong discriminant validity. The ATQ is a promising measure for the assessment of tic severity in adults with TD which may be a valuable supplement to the current recommended assessment battery for TD. Furthermore, the ATQ enables clinicians and researchers to track changes in the frequency and intensity of specific tics, which is important given their complex and dynamic nature. PMID:26520221

Alternative Fuels Data Center: Sea-Tac and Alaska Air Group Achieve

Science.gov Websites

pilot project, Alaska Air Group encountered a few hurdles during the switch to eGSE. One was Sky-High Results with Electric Ground Support Equipment Sea-Tac and Alaska Air Group Achieve Data Center: Sea-Tac and Alaska Air Group Achieve Sky-High Results with Electric Ground Support

A Midterm Review of Lesser Toe Arthrodesis With an Intramedullary Implant.

PubMed

Harmer, James Lee; Wilkinson, Anthony; Maher, Anthony John

2017-10-01

Lesser toe deformities are one of the most common conditions encountered by podiatric surgeons. When conservative treatments fail surgical correction is indicated. Many surgical options have been described to address the complex nature of these deformities but no perfect solution has been reported to date. However, with the continued advancement of internal fixation technology, interphalangeal joint (IPJ) arthrodesis with an intramedullary implant may be a good option. This retrospective study presents patient reported outcomes and complications at 6 months and 3 years following lesser toe proximal interphalangeal joint (PIPJ) arthrodesis with a polyketone intrameduallary implant (Toe Grip, Orthosolutions, UK). Between September 2011 and November 2012, a total of 38 patients attended for second toe PIPJ arthrodesis by means of the Toe Grip device. At 6 months postoperation, 94.7% of patients and at 3 years postoperation, 92.8% of patients felt that their original complaint was better or much better. Health-related quality of life scores continued to improve overtime as measured by the Manchester Oxford Foot Questionnaire. Complications were generally observational and asymptomatic. The most common complications were floating toes (17.8%), mallet deformities (14.2%), metatarsalgia (17.8%), and transverse plane deformity of the toe (10.7%). This study demonstrates excellent patient-eported outcomes with minimal symptomatic complications making the "Toe Grip" implant a safe and effective alternative fixation device for IPJ arthrodesis when dealing with painful digital deformities. Therapeutic, Level IV: Case series.

Transcranial Alternating Current Stimulation (tACS) Enhances Mental Rotation Performance during and after Stimulation

PubMed Central

Kasten, Florian H.; Herrmann, Christoph S.

2017-01-01

Transcranial alternating current stimulation (tACS) has been repeatedly demonstrated to modulate endogenous brain oscillations in a frequency specific manner. Thus, it is a promising tool to uncover causal relationships between brain oscillations and behavior or perception. While tACS has been shown to elicit a physiological aftereffect for up to 70 min, it remains unclear whether the effect can still be elicited if subjects perform a complex task interacting with the stimulated frequency band. In addition, it has not yet been investigated whether the aftereffect is behaviorally relevant. In the current experiment, participants performed a Shepard-like mental rotation task for 80 min. After 10 min of baseline measurement, participants received either 20 min of tACS at their individual alpha frequency (IAF) or sham stimulation (30 s tACS in the beginning of the stimulation period). Afterwards another 50 min of post-stimulation EEG were recorded. Task performance and EEG were acquired during the whole experiment. While there were no effects of tACS on reaction times or event-related-potentials (ERPs), results revealed an increase in mental rotation performance in the stimulation group as compared to sham both during and after stimulation. This was accompanied by increased ongoing alpha power and coherence as well as event-related-desynchronization (ERD) in the alpha band in the stimulation group. The current study demonstrates a behavioral and physiological aftereffect of tACS in parallel. This indicates that it is possible to elicit aftereffects of tACS during tasks interacting with the alpha band. Therefore, the tACS aftereffect is suitable to achieve an experimental manipulation. PMID:28197084

New treatments for tic disorders.

PubMed

Qasaymeh, Mohammad M; Mink, Jonathan W

2006-11-01

Tics vary in severity from infrequent and barely noticeable to nearly continuous and highly disruptive. Treatment of tic disorders depends on the severity of the tics, the distress they cause, and the effects they have on school, work, or daily activities. Many tics do not interfere with school or everyday life and do not require specific treatment. Comorbid disorders such as attention deficit hyperactivity disorder, anxiety, and obsessive-compulsive disorder occur in more than 50% of patients. The associated comorbidity can be more bothersome than the tics themselves. Treatment should be aimed at the most troubling symptom. Education and reassurance are often sufficient for mild and occasional tics. For tics of moderate severity, clonidine and guanfacine have a reasonable safety profile. They are considered as first-line medications. With clonidine, start with 0.05 mg at bedtime. Increase as needed and as tolerated by 0.05 mg every 4 to 7 days to a maximum dosage of 0.3 to 0.4 mg/day divided three or four times a day. With guanfacine, start with 0.5 mg at bedtime. The dosage may be increased as needed and as tolerated by 0.5 mg every week to a maximum dosage of 3 to 4 mg/day, divided twice a day. There are emerging data that behavioral therapy is effective for treatment of tics in some individuals. Dopamine receptor blockers are the most potent medications for treating severe tics. The efficacy appears to be proportionate to the affinity for dopamine D2 receptors. Thus, standard antipsychotic medications such as haloperidol, pimozide, or fluphenazine are the most potent. However, these medications commonly cause bothersome side effects. Therefore, we recommend use of atypical neuroleptics before standard neuroleptics in most patients. Risperidone is usually the first choice and may have efficacy for behavior problems that often accompany tics. Start with 0.01 mg/kg/dose once a day; dosage may be increased by 0.02 mg/kg/day at weekly intervals, up to 0.06 mg

High total antioxidant capacity of the porcine seminal plasma (SP-TAC) relates to sperm survival and fertility

PubMed Central

Barranco, Isabel; Tvarijonaviciute, Asta; Perez-Patiño, Cristina; Parrilla, Inmaculada; Ceron, Jose J.; Martinez, Emilio A.; Rodriguez-Martinez, Heriberto; Roca, Jordi

2015-01-01

The study attempted to clarify the role of total antioxidant capacity of seminal plasma (SP-TAC) on boar sperm survival and fertility after artificial insemination (AI). SP-TAC differed (P < 0.001) among boars (n° = 15) and, to a lesser degree, among ejaculates within male (4 ejaculates/boar). SP-TAC also differed (P < 0.001) among ejaculate fractions (43 ejaculates and 3 fractions per ejaculate), of which the sperm-peak portion of the sperm rich ejaculate fraction (SRF) had the highest SP-TAC. SP-TAC was not correlated with sperm quality (motility and viability) or functionality (intracellular ROS generation and lipid peroxidation) of liquid AI-semen samples stored at 17 °C for 72 h (90 AI-samples), but the decline in sperm quality was larger (P < 0.05) in ejaculates with low, compared with high SP-TAC (hierarchically grouped). The SP-TAC differences among ejaculate portions agree with sperm cryosurvival rates (14 ejaculates from 7 boars), showing sperm from sperm-peak portion better (P < 0.01) post-thaw quality and functionality than those from the entire ejaculate (mainly post-SRF). Boars (n° = 18) with high SP-TAC (hierarchically grouped) had higher (P < 0.05) fertility outcomes (5,546 AI-sows) than those with low SP-TAC. Measurement of SP-TAC ought to be a discriminative tool to prognosis fertility in breeding boars. PMID:26688188

Bupropion XL-induced motor and vocal tics.

PubMed

Kayhan, Fatih; Uguz, Faruk; Kayhan, Ayşegül; Toktaş, Fikriye Ilay

2014-01-01

Tics are stereotypical repetitive involuntary movements (motor tics) or sounds (vocal tics). Although the emergence of tics were reported in a few cases with the use of selective serotonin reuptake inhibitors, there was no case with bupropion extended-release (Bupropion XL). The current case report presents a male patient developing motor and vocal tics with the use of bupropion XL.

Is it a tic or Tourette's? Clues for differentiating simple from more complex tic disorders.

PubMed

Evidente, V G

2000-10-01

Tics are characterized by sterotyped, purposeless, and irregularly repetitive movements and usually can be classified as chronic motor or vocal tic disorders, transient tic disorders, or Tourette's syndrome. The latter is a complex disorder associated with multiple tics and often accompanied by other conditions, such as ADHD and obsessive-compulsive disorder. Treatment can be difficult, and drug therapy should begin with agents least likely to cause problems for the patient. Education of the patient and family and support from the physician and other care providers are essential elements of effective management.

TAC management in North Sea flatfish fisheries

NASA Astrophysics Data System (ADS)

Daan, Niels

1997-11-01

The Common Fisheries Policy of the European Union adopted in 1983 is primarily focused on a science-based TAC management system with fixed national quota shares. The quality of the assessments of plaice and sole, the consistency of the scientific advice, the congruency of the management decisions, and the enforcement of the regulations are reviewed over a 15-year period. The conclusion is that there have been problems at each level, with the ultimate effect that the policy has not been able to restrict fishing mortality and that the level of overexploitation has only increased. It is argued that the present TAC system has created more problems than it has resolved. Attention is drawn to the autonomic economic developments within the fishery and to the potential for managing the fishery more effectively from the cost side rather than the profit side.

Treatment of tics and tourette syndrome.

PubMed

Singer, Harvey S

2010-11-01

Tics come in a variety of types and frequencies; have a waxing and waning course; are exacerbated by stress, anxiety, and fatigue; and often resolve or improve in the teenage or early adult years. Tourette syndrome requires the presence of chronic, fluctuating motor and phonic tics. In addition to tics, individuals with Tourette syndrome often have a variety of comorbid conditions such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder, depression and anxiety, episodic outbursts, and academic difficulties. These conditions often are a greater source of difficulty than the tics themselves. All patients with tics should be evaluated to assure proper diagnosis and to identify any associated psychopathology or academic difficulty. The treatment of tics begins with education of the patient and family, including discussions about the fundamentals of tics: their characteristics, etiology, outcomes, and available treatments. Therapy should be individualized based on the extent of impairment, available support, ability to cope, and the presence of other problems. Indications for the treatment of tics include psychosocial problems (loss of self-esteem, comments from peers, excessive worries about tics, diminished participation in activities), functional difficulties, classroom disruption, and physical discomfort. A variety of behavioral approaches can be used. Recent studies have emphasized the value of comprehensive behavioral intervention for tics (CBIT). Because habit reversal is the major component of CBIT, a cooperative patient, the presence of a premonitory urge, and a committed family are essential ingredients for success. If tic-suppressing medication is required, a two-tier approach and monotherapy are recommended. First-tier medications, notably the α-adrenergic agonists, are recommended for individuals with milder tics, especially persons with both tics and ADHD. Second-tier medications include various typical and atypical

Capsulitis of the Second Toe

MedlinePlus

... second toe is a result of abnormal foot mechanics, where the ball of the foot beneath the ... options for early treatment of capsulitis: Rest and ice. Staying off the foot and applying ice packs ...

TAC Evaluation Assistance: A Ten-Year Evolution from Accountability to Program Improvement.

ERIC Educational Resources Information Center

Yap, Kim O.

The Title I/Chapter 1 Technical Assistance Centers (TACs) were originally created to provide assistance to state and local education agencies in implementing the Title I evaluation and reporting system. However, over a 10-year period, TAC role has changed significantly. Its service foci have evolved from providing evaluation assistance to helping…

The somatotopy of tic inhibition: Where and how much?

PubMed

Ganos, Christos; Bongert, Jens; Asmuss, Luisa; Martino, Davide; Haggard, Patrick; Münchau, Alexander

2015-08-01

Tics are the hallmark feature of Tourette syndrome. The basic phenomenological and neurophysiological characteristics of tics have been widely investigated. Interestingly, the spatial distribution of tics across different body parts has received little attention. No previous study has investigated whether the capacity for voluntary tic inhibition also varies across body parts. We analyzed video sequences of 26 adolescents with Tourette syndrome in a "tic freely" condition, and in a "voluntary tic inhibition" condition, to obtain absolute tic counts for different body parts. Two measures of the spatial distribution of tics were then analyzed. Linear regression analyses were employed to investigate the relation between the contribution of each body part to overall tic behavior and the ability to inhibit tics in that body part, averaged over our patient group. Tic distribution across patients showed a characteristic somatotopic pattern, with the face most strongly represented. A significant negative relation was found between the ability to inhibit tics and pooled tic frequency across body parts. The body parts that exhibited the fewest tics were the ones for which tic inhibition was most effective. Our data are consistent with the idea that tic recruitment order reflects a "tic generator" spreading across a somatotopic map in the brain. Voluntary tic inhibition did not simply cause a proportional reduction of tics in each body part. Rather, the least affected body parts showed most effective voluntary tic inhibition. The results are discussed in terms of signal and noise within cortical-subcortical motor loops. © 2015 International Parkinson and Movement Disorder Society.

Motor Tics, Tourette Syndrome, and Learning Disabilities.

ERIC Educational Resources Information Center

Lerer, Robert J.

1987-01-01

Complex motor tics associated with vocal tics indicate a high likelihood of Tourette syndrome; children with this syndrome may also have learning disabilities and attentional disorders. Individuals may be treated with stimulant drugs which may precipitate or exacerbate tics. Pharmacotherapy is available for management of tics and attentional…

Surface modifications on toughened, fine-grained, recrystallized tungsten with repetitive ELM-like pulsed plasma irradiation

NASA Astrophysics Data System (ADS)

Kikuchi, Y.; Sakuma, I.; Kitagawa, Y.; Asai, Y.; Onishi, K.; Fukumoto, N.; Nagata, M.; Ueda, Y.; Kurishita, H.

2015-08-01

Surface modifications of toughened, fine-grained, recrystallized tungsten (TFGR W) materials with 1.1 wt.% TiC and 3.3 wt.% TaC dispersoids due to repetitive ELM-like pulsed (∼0.15 ms) helium plasma irradiation have been investigated by using a magnetized coaxial plasma gun. No surface cracking at the center part of the TFGR W samples exposed to 20 plasma pulses of ∼0.3 MJ m-2 was observed. The suppression of surface crack formation due to the increase of the grain boundary strength by addition of TiC and TaC dispersoids was confirmed in comparison with a pure W material. On the other hand, surface cracks and small pits appeared at the edge part of the TFGR W sample after the pulsed plasma irradiation. Erosion of the TiC and TaC dispersoids due to the pulsed plasma irradiation could cause the small pits on the surface, resulting in the surface crack formation.

Modeling the effect of toe clipping on treefrog survival: Beyond the return rate

USGS Publications Warehouse

Waddle, J.H.; Rice, K.G.; Mazzotti, F.J.; Percival, H.F.

2008-01-01

Some studies have described a negative effect of toe clipping on return rates of marked anurans, but the return rate is limited in that it does not account for heterogeneity of capture probabilities. We used open population mark-recapture models to estimate both apparent survival (ϕ) and the recapture probability (p) of two treefrog species individually marked by clipping 2–4 toes. We used information-theoretic model selection to examine the effect of toe clipping on survival while accounting for variation in capture probability. The model selection results indicate strong support for an effect of toe clipping on survival of Green Treefrogs (Hyla cinerea) and only limited support for an effect of toe clipping on capture probability. We estimate there was a mean absolute decrease in survival of 5.02% and 11.16% for Green Treefrogs with three and four toes removed, respectively, compared to individuals with just two toes removed. Results for Squirrel Treefrogs (Hyla squirella) indicate little support for an effect of toe clipping on survival but may indicate some support for a negative effect on capture probability. We believe that the return rate alone should not be used to examine survival of marked animals because constant capture probability must be assumed, and our examples demonstrate how capture probability may vary over time and among groups. Mark-recapture models provide a method for estimating the effect of toe clipping on anuran survival in situations where unique marks are applied.

Targeting the neurophysiology of cognitive systems with transcranial alternating current stimulation (tACS)

PubMed Central

Fröhlich, Flavio; Sellers, Kristin K.; Cordle, Asa L.

2015-01-01

Cognitive impairment represents one of the most debilitating and most difficult symptom to treat of many psychiatric illnesses. Human neurophysiology studies have suggested specific pathologies of cortical network activity correlate with cognitive impairment. However, we lack (1) demonstration of causal relationships between specific network activity patterns and cognitive capabilities and (2) treatment modalities that directly target impaired network dynamics of cognition. Transcranial alternating current stimulation (tACS), a novel non-invasive brain stimulation approach, may provide a crucial tool to tackle these challenges. We here propose that tACS can be used to elucidate the causal role of cortical synchronization in cognition and, eventually, to enhance pathologically weakened synchrony that may underlie cognitive deficits. To accelerate such development of tACS as a treatment for cognitive deficits, we discuss studies on tACS and cognition (all performed in healthy participants) according to the Research Domain Criteria (RDoC) of the National Institute of Mental Health. PMID:25547149

Age-related reduction and independent predictors of toe flexor strength in middle-aged men.

PubMed

Suwa, Masataka; Imoto, Takayuki; Kida, Akira; Iwase, Mitsunori; Yokochi, Takashi

2017-01-01

Toe flexor muscles play an important role in posture and locomotion, and poor toe flexor strength is a risk factor for falls. In this cross-sectional study, we estimated the age-related change in toe flexor strength and compared it with that of handgrip strength. Independent factors predicting toe flexor and handgrip strength were also determined. A total of 1401 male (aged 35-59 years) study participants were divided into five groups according to their chronological age; 35-39, 40-44, 45-49, 50-54, and 55-59 years. Toe flexor and handgrip strength, anthropometry, and resting blood pressure were measured. Fasting blood samples were collected to measure blood glucose, triglycerides, high- and low-density lipoprotein-cholesterols, and albumin. A self-administered lifestyle questionnaire was conducted. Decline in absolute toe flexor and handgrip strength began in the age groups 50-55 and 55-59 years, respectively. In comparison to the mean values of the youngest group, relative toe flexor strength (87.0 ± 26.6%) was significantly lower than handgrip strength (94.4 ± 13.1%) for the oldest group. Multiple regression analyses showed that independent factors predicting both toe flexor and handgrip strength were lean body mass, age, serum albumin, drinking habit, and fat mass. Additionally, fasting blood glucose, diastolic blood pressure, sleeping time and exercise habit were predicting factors of toe flexor strength but not of handgrip strength. Age-related reduction in toe flexor strength was earlier and greater than handgrip strength, and toe flexor strength reflects body composition and metabolic status.

Interventions for treating osteoarthritis of the big toe joint.

PubMed

Zammit, Gerard V; Menz, Hylton B; Munteanu, Shannon E; Landorf, Karl B; Gilheany, Mark F

2010-09-08

Osteoarthritis affecting of the big toe joint of the foot (hallux limitus or rigidus) is a common and painful condition. Although several treatments have been proposed, few have been adequately evaluated. To identify controlled trials evaluating interventions for osteoarthritis of the big toe joint and to determine the optimum intervention(s). Literature searches were conducted across the following electronic databases: CENTRAL; MEDLINE; EMBASE; CINAHL; and PEDro (to 14th January 2010). No language restrictions were applied. Randomised controlled trials, quasi-randomised trials, or controlled clinical trials that assessed treatment outcomes for osteoarthritis of the big toe joint. Participants of any age or gender with osteoarthritis of the big toe joint (defined either radiographically or clinically) were included. Two authors examined the list of titles and abstracts identified by the literature searches. One content area expert and one methodologist independently applied the pre-determined inclusion and exclusion criteria to the full text of identified trials. To minimise error and reduce potential bias, data were extracted independently by two content experts. Only one trial satisfactorily fulfilled the inclusion criteria and was included in this review. This trial evaluated the effectiveness of two physical therapy programs in 20 individuals with osteoarthritis of the big toe joint. Assessment outcomes included pain levels, big toe joint range of motion and plantar flexion strength of the hallux. Mean differences at four weeks follow up were 3.80 points (95% CI 2.74 to 4.86) for self reported pain, 28.30 degrees (95% CI 21.37 to 35.23) for big toe joint range of motion, and 2.80 kg (95% CI 2.13 to 3.47) for muscle strength. Although differences in outcomes between treatment and control groups were reported, the risk of bias was high. The trial failed to employ appropriate randomisation or adequate allocation concealment, used a relatively small sample and

Assessing Environmental Consequences of Ticcing in Youth with Chronic Tic Disorders: The Tic Accommodation and Reactions Scale

PubMed Central

Capriotti, Matthew R.; Piacentini, John C.; Himle, Michael B.; Ricketts, Emily J.; Espil, Flint M.; Lee, Han Joo; Turkel, Jennifer E.; Woods, Douglas W.

2015-01-01

Tics associated with Tourette syndrome and other chronic tic disorders (CTDs) often draw social reactions and disrupt ongoing behavior. In some cases, such tic-related consequences may function to alter moment-to-moment and future tic severity. These observations have been incorporated into contemporary biopsychosocial models of CTD phenomenology, but systematic research detailing the nature of the relationship between environmental consequences and ticcing remains scarce. This study describes the development of the Tic Accommodation and Reactions Scale (TARS), a measure of the number and frequency of immediate consequences for ticcing experienced by youth with CTDs. Thirty eight youth with CTDs and their parents completed the TARS as part of a broader assessment of CTD symptoms and psychosocial functioning. The TARS demonstrated good psychometric properties (i.e., internal consistency, parent-child agreement, convergent validity, discriminant validity). Differences between parent-reported and child-reported data indicated that children may provide more valid reports of tic-contingent consequences than parents. Although preliminary, results of this study suggest that the TARS is a psychometrically sound measure of tic-related consequences suited for future research in youth with CTDs. PMID:27076696

Psychosocial Intervention for Young Children With Chronic Tics

ClinicalTrials.gov

2018-06-18

Tourette's Syndrome; Tourette's Disorder; Tourette's Disease; Tourette Disorder; Tourette Disease; Tic Disorder, Combined Vocal and Multiple Motor; Multiple Motor and Vocal Tic Disorder, Combined; Gilles de La Tourette's Disease; Gilles de la Tourette Syndrome; Gilles De La Tourette's Syndrome; Combined Vocal and Multiple Motor Tic Disorder; Combined Multiple Motor and Vocal Tic Disorder; Chronic Motor and Vocal Tic Disorder

Fatigue Magnification Factors of Arc-Soft-Toe Bracket Joints

NASA Astrophysics Data System (ADS)

Fu, Qiang; Li, Huajun; Wang, Hongqing; Wang, Shuqing; Li, Dejiang; Li, Qun; Fang, Hui

2018-06-01

Arc-soft-toe bracket (ASTB), as a joint structure in the marine structure, is the hot spot with significant stress concentration, therefore, fatigue behavior of ASTBs is an important point of concern in their design. Since macroscopic geometric factors obviously influence the stress flaws in joints, the shapes and sizes of ASTBs should represent the stress distribution around cracks in the hot spots. In this paper, we introduce a geometric magnification factor for reflecting the macroscopic geometric effects of ASTB crack features and construct a 3D finite element model to simulate the distribution of stress intensity factor (SIF) at the crack endings. Sensitivity analyses with respect to the geometric ratio H t / L b , R/ L b , L t / L b are performed, and the relations between the geometric factor and these parameters are presented. A set of parametric equations with respect to the geometric magnification factor is obtained using a curve fitting technique. A nonlinear relationship exists between the SIF and the ratio of ASTB arm to toe length. When the ratio of ASTB arm to toe length reaches a marginal value, the SIF of crack at the ASTB toe is not influenced by ASTB geometric parameters. In addition, the arc shape of the ASTB slope edge can transform the stress flowing path, which significantly affects the SIF at the ASTB toe. A proper method to reduce stress concentration is setting a slope edge arc size equal to the ASTB arm length.

Effects of the TiC Nanoparticle on Microstructures and Tensile Properties of Selective Laser Melted IN718/TiC Nanocomposites

NASA Astrophysics Data System (ADS)

Yao, Xiling; Moon, Seung Ki; Lee, Bing Yang; Bi, Guijun

2018-03-01

The purpose of this paper is to investigate the effects of TiC nanoparticle content on microstructures and tensile properties of the IN718/TiC nanocomposites fabricated by selective laser melting (SLM). 0.5wt%, 1.0wt%, and 2.0wt% of TiC nanoparticles are added to the IN718 powders. The bulk-form IN718/TiC nanocomposites with different TiC contents are fabricated in-situ by SLM using the same process settings. The evolution of microstructures and tensile properties as the effect of changing the TiC content is studied using the optical microscopy, scanning electron microscopy, X-ray diffraction analysis, and tensile testing. The increase of TiC content refines the microstructure, promotes the formation of the cellular morphology, and reduces the size and continuity of Laves precipitates. Increasing the TiC content improves the yield strength and ultimate tensile strength but decreases the ductility. The grain refinement, dislocation bowing, dislocation punching, and the reduction in Laves precipitate contribute to the strengthening effect in the IN718/TiC nanocomposites.

Modified toe pulp fillet flap coverage: Better wound healing and satisfactory length preservation.

PubMed

Baek, Sang Oon; Suh, Hyo Wan; Lee, Jun Yong

2018-01-01

Amputation is commonly performed for toe necrosis secondary to peripheral vascular diseases, such as diabetes mellitus. When amputating a necrotic toe, preservation of the bony structure is important for preventing the collapse of adjacent digits into the amputated space. However, in the popular terminal Syme's amputation technique, partial amputation of the distal phalanx could cause increased tension on the wound margin. Herein, we introduce a new way to resect sufficient bony structure while maintaining the normal length, based on a morphological analysis of the toes. Unlike the pulp of the finger in the distal phalanx, the toe has abundant teardrop-shaped pulp tissue. The ratio of the vertical length to the longitudinal length in the distal phalanx was compared between the toes and fingers. Amputation was performed at the proximal interphalangeal joint level. Then, a mobilizable pulp flap was rotated 90° cephalad to replace the distal soft tissue defect. This modified toe fillet flap was performed in 5 patients. The toe pulp was found to have a vertically oriented morphology compared to that of the fingers, enabling length preservation through cephalad rotation. All defects were successfully covered without marginal ischemia. While conventional toe fillet flap coverage focuses on the principle of length preservation as the first priority, our modified method takes both wound healing and length into account. The fattiest part of the pulp is advanced to the toe tip, providing a cushioning effect and enough length to substitute for phalangeal bone loss. Our modified method led to satisfactory functional and aesthetic outcomes.

The Essential tacF Gene Is Responsible for the Choline-Dependent Growth Phenotype of Streptococcus pneumoniae▿

PubMed Central

Damjanovic, Marlen; Kharat, Arun S.; Eberhardt, Alice; Tomasz, Alexander; Vollmer, Waldemar

2007-01-01

Streptococcus pneumoniae has an absolute nutritional requirement for choline, and the choline molecules are known to incorporate exclusively into the cell wall and membrane teichoic acids of the bacterium. We describe here the isolation of a mutant of strain R6 in which a single G→T point mutation in the gene tacF (formerly designated spr1150) is responsible for generating a choline-independent phenotype. The choline-independent phenotype could be transferred to the laboratory strain R6 and to the encapsulated strain D39 by genetic transformation with a PCR product or with a plasmid carrying the mutated tacF gene. The tacF gene product belongs to the protein family of polysaccharide transmembrane transporters (flippases). A model is presented in which TacF is required for the transport of the teichoic acid subunits across the cytoplasmic membrane. According to this model, wild-type TacF has a strict specificity for choline-containing subunits, whereas the TacF present in the choline-independent mutant strain is able to transport both choline-containing and choline-free teichoic acid chains. The proposed transport specificity of parental-type TacF for choline-containing subunits would ensure the loading of the cell wall with teichoic acid chains decorated with choline residues, which appear to be essential for the virulence of this pathogen. PMID:17660291

Measurement of Toe-Brachial Indices in People with Subnormal Toe Pressures Complexities and Revelations.

PubMed

McAra, Sylvia; Trevethan, Robert

2018-03-01

Insufficient information exists about the nature of toe-brachial indices (TBIs) and how best to obtain them, yet their validity may be particularly important for the identification and management of peripheral artery disease and cardiovascular disease risk. We explore ways in which valid TBI measurements might be obtained. The TBI data were recorded from 97 people with subnormal toe pressures. Most people provided three TBI readings from each foot on six different occasions over a 6-month period. The foot with the lower baseline TBI was noted. For most people, only small inconsistencies existed among the three readings taken from each foot on a single occasion, and there were no consistent differences based on sequence. However, for some people there were noticeable and unsystematic differences among the measures. Selecting any specific one of the three readings based on its sequential position, or averaging specific readings, did not yield TBIs that were unequivocally typical for a person, and taking the lowest reading of each set seemed to offer the most expedient solution in this context. That permitted baseline descriptive statistics to be produced for both the higher and lower pressure feet, between which there was a statistically significant TBI difference. Accurate and consistent TBI readings cannot be assumed for people with subnormal toe pressures, and taking only a single reading or indiscriminately averaging readings seems inadvisable. Two readings and, if they are discrepant, additional readings, are recommended for each foot, ideally on several occasions, and careful consideration should be given to determine the most representative reading for each foot. Cuff sizes and other sources of inaccuracy or distortion should not be ignored, and standardized protocols for obtaining TBIs are recommended.

Voluntary inhibitory motor control over involuntary tic movements.

PubMed

Ganos, Christos; Rothwell, John; Haggard, Patrick

2018-03-06

Inhibitory control is crucial for normal adaptive motor behavior. In hyperkinesias, such as tics, disinhibition within the cortico-striato-thalamo-cortical loops is thought to underlie the presence of involuntary movements. Paradoxically, tics are also subject to voluntary inhibitory control. This puzzling clinical observation questions the traditional definition of tics as purely involuntary motor behaviors. Importantly, it suggests novel insights into tic pathophysiology. In this review, we first define voluntary inhibitory tic control and compare it with other notions of tic control from the literature. We then examine the association between voluntary inhibitory tic control with premonitory urges and review evidence linking voluntary tic inhibition to other forms of executive control of action. We discuss the somatotopic selectivity and the neural correlates of voluntary inhibitory tic control. Finally, we provide a scientific framework with regard to the clinical relevance of the study of voluntary inhibitory tic control within the context of the neurodevelopmental disorder of Tourette syndrome. We identify current knowledge gaps that deserve attention in future research. © 2018 International Parkinson and Movement Disorder Society. © 2018 International Parkinson and Movement Disorder Society.

Tic Disorders and PANDAS.

PubMed

Blackburn, Joanna S

2018-04-01

Tics are the most common movement disorder in childhood and are a frequent reason for referral to child neurology clinics. The purpose of this review is to examine the phenomenology of tics, discuss what is known regarding their genetic and pathophysiological causes and to evaluate current treatment options. The evidence for the evaluation and treatment of the controversial diagnosis of pediatric autoimmune neuropsychiatric disorders associated with group A streptococci (PANDAS) will also be reviewed. With improved understanding of tic disorders, their etiology and response to current treatment options, we may be able to more effectively diagnose them and identify novel treatment strategies. Copyright © 2018 Elsevier Inc. All rights reserved.

Cytokine correlations in youth with tic disorders.

PubMed

Parker-Athill, E Carla; Ehrhart, Jared; Tan, Jun; Murphy, Tanya K

2015-02-01

Studies have noted immunological disruptions in patients with tic disorders, including increased serum cytokine levels. This study aimed to determine whether or not cytokine levels could be correlated with tic symptom severity in patients with a diagnosed tic disorder. Twenty-one patients, ages 4-17 years (average 10.63±2.34 years, 13 males), with a clinical diagnosis of Tourette's syndrome (TS) or chronic tic disorder (CTD), were selected based on having clinic visits that coincided with a tic symptom exacerbation and a remission. Ratings of tic severity were assessed using the Yale Global Tic Severity Scale (YGTSS) and serum cytokine levels (interleukin [IL]-2, IL-4, IL-5, IL-10, IL-12p70, IL-13, interferon [IFN]-γ, tumor necrosis factor [TNF]-α, and granulocyte macrophage-colony stimulating factor [GM-CSF]) were measured using Luminex xMAP technology. During tic symptom exacerbation, patients had higher median serum TNF-α levels (z=-1.962, p=0.05), particularly those on antipsychotics (U=9.00, p=0.033). Increased IL-13 was also associated with antipsychotic use during exacerbation (U=4.00, p=0.043) despite being negatively correlated to tic severity scores (ρ=-0.599, p=018), whereas increased IL-5 was associated with antibiotic use (U=6.5, p=0.035). During tic symptom remission, increased serum IL-4 levels were associated with antipsychotic (U=6.00, p=0.047) and antibiotic (U=1.00, p=0.016) use, whereas increased IL-12p70 (U=4.00, p=0.037) was associated with antibiotic use. These findings suggest a role for cytokine dysregulation in the pathogenesis of tic disorders. It also points toward the mechanistic involvement and potential diagnostic utility of cytokine monitoring, particularly TNF-α levels. Larger, systematic studies are necessary to further delineate the role of cytokines and medication influences on immunological profiling in tic disorders.

Cytokine Correlations in Youth with Tic Disorders

PubMed Central

Parker-Athill, E. Carla; Ehrhart, Jared; Tan, Jun

2015-01-01

Abstract Background: Studies have noted immunological disruptions in patients with tic disorders, including increased serum cytokine levels. This study aimed to determine whether or not cytokine levels could be correlated with tic symptom severity in patients with a diagnosed tic disorder. Methods: Twenty-one patients, ages 4–17 years (average 10.63±2.34 years, 13 males), with a clinical diagnosis of Tourette's syndrome (TS) or chronic tic disorder (CTD), were selected based on having clinic visits that coincided with a tic symptom exacerbation and a remission. Ratings of tic severity were assessed using the Yale Global Tic Severity Scale (YGTSS) and serum cytokine levels (interleukin [IL]-2, IL-4, IL-5, IL-10, IL-12p70, IL-13, interferon [IFN]-γ, tumor necrosis factor [TNF]-α, and granulocyte macrophage-colony stimulating factor [GM-CSF]) were measured using Luminex xMAP technology. Results: During tic symptom exacerbation, patients had higher median serum TNF-α levels (z=−1.962, p=0.05), particularly those on antipsychotics (U=9.00, p=0.033). Increased IL-13 was also associated with antipsychotic use during exacerbation (U=4.00, p=0.043) despite being negatively correlated to tic severity scores (ρ=−0.599, p=018), whereas increased IL-5 was associated with antibiotic use (U=6.5, p=0.035). During tic symptom remission, increased serum IL-4 levels were associated with antipsychotic (U=6.00, p=0.047) and antibiotic (U=1.00, p=0.016) use, whereas increased IL-12p70 (U=4.00, p=0.037) was associated with antibiotic use. Conclusions: These findings suggest a role for cytokine dysregulation in the pathogenesis of tic disorders. It also points toward the mechanistic involvement and potential diagnostic utility of cytokine monitoring, particularly TNF-α levels. Larger, systematic studies are necessary to further delineate the role of cytokines and medication influences on immunological profiling in tic disorders. PMID:25658821

Linking clinical measurements and kinematic gait patterns of toe-walking using fuzzy decision trees.

PubMed

Armand, Stéphane; Watelain, Eric; Roux, Emmanuel; Mercier, Moïse; Lepoutre, François-Xavier

2007-03-01

Toe-walking is one of the most prevalent gait deviations and has been linked to many diseases. Three major ankle kinematic patterns have been identified in toe-walkers, but the relationships between the causes of toe-walking and these patterns remain unknown. This study aims to identify these relationships. Clearly, such knowledge would increase our understanding of this gait deviation, and could help clinicians plan treatment. The large quantity of data provided by gait analysis often makes interpretation a difficult task. Artificial intelligence techniques were used in this study to facilitate interpretation as well as to decrease subjective interpretation. Of the 716 limbs evaluated, 240 showed signs of toe-walking and met inclusion criteria. The ankle kinematic pattern of the evaluated limbs during gait was assigned to one of three toe-walking pattern groups to build the training data set. Toe-walker clinical measurements (range of movement, muscle spasticity and muscle strength) were coded in fuzzy modalities, and fuzzy decision trees were induced to create intelligible rules allowing toe-walkers to be assigned to one of the three groups. A stratified 10-fold cross validation situated the classification accuracy at 81%. Twelve rules depicting the causes of toe-walking were selected, discussed and characterized using kinematic, kinetic and EMG charts. This study proposes an original approach to linking the possible causes of toe-walking with gait patterns.

Early reduction in toe flexor strength is associated with physical activity in elderly men.

PubMed

Suwa, Masataka; Imoto, Takayuki; Kida, Akira; Yokochi, Takashi

2016-05-01

[Purpose] To compare the toe flexor, hand grip and knee extensor strengths of young and elderly men, and to examine the association between toe flexor strength and physical activity or inactivity levels. [Subjects and Methods] Young (n=155, 18-23 years) and elderly (n=60, 65-88 years) men participated in this study. Toe flexor, hand grip, and knee extensor strength were measured. Physical activity (time spent standing/walking per day) and inactivity (time spent sitting per day) were assessed using a self-administered questionnaire. [Results] Toe flexor, hand grip, and knee extensor strength of the elderly men were significantly lower than those of the young men. Standing/walking and sitting times of the elderly men were lower than those of the young men. Toe flexor strength correlated with hand grip and knee extensor strength in both groups. In elderly men, toe flexor strength correlated with standing/walking time. In comparison to the young men's mean values, toe flexor strength was significantly lower than knee extensor and hand grip strength in the elderly group. [Conclusion] The results suggest that age-related reduction in toe flexor strength is greater than those of hand grip and knee extensor strengths. An early loss of toe flexor strength is likely associated with reduced physical activity in elderly men.

Early reduction in toe flexor strength is associated with physical activity in elderly men

PubMed Central

Suwa, Masataka; Imoto, Takayuki; Kida, Akira; Yokochi, Takashi

2016-01-01

[Purpose] To compare the toe flexor, hand grip and knee extensor strengths of young and elderly men, and to examine the association between toe flexor strength and physical activity or inactivity levels. [Subjects and Methods] Young (n=155, 18–23 years) and elderly (n=60, 65–88 years) men participated in this study. Toe flexor, hand grip, and knee extensor strength were measured. Physical activity (time spent standing/walking per day) and inactivity (time spent sitting per day) were assessed using a self-administered questionnaire. [Results] Toe flexor, hand grip, and knee extensor strength of the elderly men were significantly lower than those of the young men. Standing/walking and sitting times of the elderly men were lower than those of the young men. Toe flexor strength correlated with hand grip and knee extensor strength in both groups. In elderly men, toe flexor strength correlated with standing/walking time. In comparison to the young men’s mean values, toe flexor strength was significantly lower than knee extensor and hand grip strength in the elderly group. [Conclusion] The results suggest that age-related reduction in toe flexor strength is greater than those of hand grip and knee extensor strengths. An early loss of toe flexor strength is likely associated with reduced physical activity in elderly men. PMID:27313353

GUTs and TOEs

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lincoln, Don

2015-01-20

Albert Einstein said that what he wanted to know was “God’s thoughts,” which is a metaphor for the ultimate and most basic rules of the universe. Once known, all other phenomena would then be a consequence of these simple rules. While modern science is far from that goal, we have some thoughts on how this inquiry might unfold. In this video, Fermilab’s Dr. Don Lincoln tells what we know about GUTs (grand unified theories) and TOEs (theories of everything).

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

30 CFR 56.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Fixed ladder anchorage and toe clearance. 56.11005 Section 56.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... Travelways § 56.11005 Fixed ladder anchorage and toe clearance. Fixed ladders shall be anchored securely and...

Alteration of TAC1 expression in Prunus species leads to pleiotropic shoot phenotypes

USDA-ARS?s Scientific Manuscript database

Prunus persica (peach) trees carrying the ‘Pillar’ or ‘Broomy’ trait (br) have vertically oriented branches caused by loss of function mutations in a gene called TILLER ANGLE CONTROL 1 (TAC1). TAC1 encodes a protein in the IGT gene family that includes LAZY1 and DEEPER ROOTING 1 (DRO1), which regul...

An Integrated Theory of Everything (TOE)

NASA Astrophysics Data System (ADS)

Colella, Antonio

2014-03-01

An Integrated TOE unifies all known physical phenomena from the Planck cube to the Super Universe (multiverse). Each matter/force particle is represented by a Planck cube string. Any Super Universe object is a volume of contiguous Planck cubes. Super force Planck cube string singularities existed at the start of all universes. An Integrated TOE foundations are twenty independent existing theories and without sacrificing their integrities, are replaced by twenty interrelated amplified theories. Amplifications of Higgs force theory are key to an Integrated TOE and include: 64 supersymmetric Higgs particles; super force condensations to 17 matter particles/associated Higgs forces; spontaneous symmetry breaking is bidirectional; and the sum of 8 permanent Higgs force energies is dark energy. Stellar black hole theory was amplified to include a quark star (matter) with mass, volume, near zero temperature, and maximum entropy. A black hole (energy) has energy, minimal volume (singularity), near infinite temperature, and minimum entropy. Our precursor universe's super supermassive quark star (matter) evaporated to a super supermassive black hole (energy). This transferred total conserved energy/mass and transformed entropy from maximum to minimum. Integrated Theory of Everything Book Video: https://www.youtube.com/watch?v=4a1c9IvdoGY Research Article Video: http://www.youtube.com/watch?v=CD-QoLeVbSY Research Article: http://toncolella.files.wordpress.com/2012/07/m080112.pdf.

U.S. Accession to ASEAN’s Treaty of Amity and Cooperation (TAC)

DTIC Science & Technology

2009-05-05

3 ASEAN’s History and Evolution .....................................................................................7 Overview of TAC...Burma, see Australian Department of Foreign Affairs and Trade, Burma Country Brief – March 2009; Andrew Selth, “Burma’s ‘ Saffron Revolution’ and the...August 2008. U.S. Accession to ASEAN’s Treaty of Amity and Cooperation (TAC) Congressional Research Service 7 ASEAN’s History and Evolution

Operative Outcomes of Grade 3 Turf Toe Injuries in Competitive Football Players.

PubMed

Smith, Kenneth; Waldrop, Norman

2018-06-01

Turf toe is a term used to describe a hyperextension injury to the first metatarsophalangeal joint. Although the vast majority of turf toe injuries can be treated successfully without operative intervention, there are instances where surgery is required to allow the athlete to return to play. Although there is a plethora of literature on turf toe injuries and nonoperative management, there are currently few reports on operative outcomes in athletes. We obtained all cases of turf toe repair according to the ICD-10 procedural code. The inclusion criteria included: age greater than 16, turf toe injury requiring operative management and at least a varsity level high school football player. The charts were reviewed for age, BMI, level of competition, injury mechanism, football position, setting of injury and playing surface. In addition, we recorded the specifics of the operative procedure, a listing of all injured structures, the implants used and the great toe range of motion at final follow-up visit. The AOFAS Hallux score and VAS was used postoperatively as our outcome measures. Our patient population included 15 patients. The average follow-up time was 27.5 months. The average patient was 19.3 years old with a body mass index of 32.3. The average playing time missed was 16.5 weeks. The average dorsiflexion range of motion at the final follow-up was 42.3 degrees. At final follow-up, the average AOFAS Hallux score was 91.3. The average VAS pain score was 0.7 at rest and 0.8 with physical activity. Complete turf toe injuries are often debilitating and may require operative management to restore a pain-free, stable, and functional forefoot. This study represents the largest cohort of operatively treated grade 3 turf toe injuries in the literature and demonstrates that good clinical outcomes were achieved with operative repair. Level IV, case series.

Molecular cloning and identification of the transcriptional regulatory domain of the goat neurokinin B gene TAC3.

PubMed

Suetomi, Yuta; Matsuda, Fuko; Uenoyama, Yoshihisa; Maeda, Kei-ichiro; Tsukamura, Hiroko; Ohkura, Satoshi

2013-10-01

Neurokinin B (NKB), encoded by TAC3, is thought to be an important accelerator of pulsatile gonadotropin-releasing hormone release. This study aimed to clarify the transcriptional regulatory mechanism of goat TAC3. First, we determined the full-length mRNA sequence of goat TAC3 from the hypothalamus to be 820 b, including a 381 b coding region, with the putative transcription start site located 143-b upstream of the start codon. The deduced amino acid sequence of NKB, which is produced from preproNKB, was completely conserved among goat, cattle, and human. Next, we cloned 5'-upstream region of goat TAC3 up to 3400 b from the translation initiation site, and this region was highly homologous with cattle TAC3 (89%). We used this goat TAC3 5'-upstream region to perform luciferase assays. We created a luciferase reporter vector containing DNA constructs from -2706, -1837, -834, -335, or -197 to +166 bp (the putative transcription start site was designated as +1) of goat TAC3 and these were transiently transfected into mouse hypothalamus-derived N7 cells and human neuroblastoma-derived SK-N-AS cells. The luciferase activity gradually increased with the deletion of the 5'-upstream region, suggesting that the transcriptional suppressive region is located between -2706 and -336 bp and that the core promoter exists downstream of -197 bp. Estradiol treatment did not lead to significant suppression of luciferase activity of any constructs, suggesting the existence of other factor(s) that regulate goat TAC3 transcription.

Is There a Relationship Between Tic Frequency and Physiological Arousal? Examination in a Sample of Children with Co-Occurring Tic and Anxiety Disorders

PubMed Central

Conelea, Christine A.; Ramanujam, Krishnapriya; Walther, Michael R.; Freeman, Jennifer B.; Garcia, Abbe M.

2014-01-01

Stress is the contextual variable most commonly implicated in tic exacerbations. However, research examining associations between tics, stressors, and the biological stress response has yielded mixed results. This study examined whether tics occur at a greater frequency during discrete periods of heightened physiological arousal. Children with co-occurring tic and anxiety disorders (n = 8) completed two stress induction tasks (discussion of family conflict, public speech). Observational (tic frequencies) and physiological (heart rate) data were synchronized using The Observer XT, and tic frequencies were compared across periods of high and low heart rate. Tic frequencies across the entire experiment did not increase during periods of higher heart rate. During the speech task, tic frequencies were significantly lower during periods of higher heart rate. Results suggest that tic exacerbations may not be associated with heightened physiological arousal and highlight the need for further tic research using integrated measurement of behavioral and biological processes. PMID:24662238

Is There a Relationship Between Tic Frequency and Physiological Arousal? Examination in a Sample of Children With Co-Occurring Tic and Anxiety Disorders.

PubMed

Conelea, Christine A; Ramanujam, Krishnapriya; Walther, Michael R; Freeman, Jennifer B; Garcia, Abbe M

2014-03-01

Stress is the contextual variable most commonly implicated in tic exacerbations. However, research examining associations between tics, stressors, and the biological stress response has yielded mixed results. This study examined whether tics occur at a greater frequency during discrete periods of heightened physiological arousal. Children with co-occurring tic and anxiety disorders (n = 8) completed two stress-induction tasks (discussion of family conflict, public speech). Observational (tic frequencies) and physiological (heart rate [HR]) data were synchronized using The Observer XT, and tic frequencies were compared across periods of high and low HR. Tic frequencies across the entire experiment did not increase during periods of higher HR. During the speech task, tic frequencies were significantly lower during periods of higher HR. Results suggest that tic exacerbations may not be associated with heightened physiological arousal and highlight the need for further tic research using integrated measurement of behavioral and biological processes. © The Author(s) 2014.

The relation between attention and tic generation in Tourette syndrome.

PubMed

Misirlisoy, Erman; Brandt, Valerie; Ganos, Christos; Tübing, Jennifer; Münchau, Alexander; Haggard, Patrick

2015-07-01

Many neuropsychiatric disorders involve abnormal attentional processing. Systematic investigations of how attention may affect tic frequency in Tourette syndrome are lacking. Patients performed rhythmic finger movements, approximately once every 2 s. Each movement triggered a unique visual color stimulus. Patients were asked to monitor and remember their finger actions, the external colors caused by their actions, or their tics. Sixteen adult Tourette syndrome patients performed each task twice: once while inhibiting tics, and once without inhibiting tics. During the "freely tic" condition, patients had significantly fewer tics when attending to finger movements, or to the ensuing colors, compared with when attending to their tics. Attention to fingers produced the fewest tics overall. During tic suppression, tic frequency was reduced to an equal level in all conditions. Focusing attention away from tics significantly reduces tic frequency. This attentional process may operate by regulating motor noise. (c) 2015 APA, all rights reserved).

Effect of toe extension on EMG of triceps surae muscles during isometric dorsiflexion.

PubMed

Siddiqi, Ariba; Arjunan, Sridhar P; Kumar, Dinesh

2016-12-01

The protocol for estimating force of contraction by triceps surae (TS) muscles requires the immobilization of the ankle during dorsiflexion and plantar flexion. However, large variability in the results has been observed. To identify the cause of this variability, experiments were conducted where ankle dorsiflexion force and electromyogram (EMG) of the TS were recorded under two conditions: (i) toes were strapped and (ii) toes were unstrapped, with all other conditions such as immobilization of the ankle remaining unchanged. The root mean square (RMS) of the EMG and the force were analyzed and one-tail Student's t-test was performed for significance between the two conditions. The RMS of the EMG from TS muscles was found to be significantly higher (~55%) during dorsiflexion with toes unstrapped compared with when the toes were strapped. The torque corresponding to dorsiflexion was also higher with toes unstrapped. Our study has shown that it is important to strap the toes when measuring the torque at the ankle and EMG of the TS muscles.

Comprehensive Behavioral Intervention for Tics in Children with Tourette Syndrome

ERIC Educational Resources Information Center

Woods, Douglas W.; Piacentini, John C.; Walkup, John T.

2010-01-01

Tourette syndrome (TS) is one of three separate tic disorders. By definition, children with TS must have at least two motor (movement) tics and one vocal (or sound tic) for at least a year. The other tic disorders are chronic tic disorder (motor or vocal tics, but not both for at least one year) and transient tic disorder (motor and/or vocal tics…

CBR/TIC Filter Design and Evaluation

DTIC Science & Technology

2006-12-29

CBR/TIC Filters Aged CK Filter Life Predicitions.................................................................. 29 Figure 30. CBR/TIC Filters...potting adhesive. Neoprene rubber face gaskets are adhered to each end of the particulate filter for airtight sealing. Figure 16. CBR/TIC HEPA...attached with adhesive to the bottom end cover and is spaced by the compression pads on the top end. EPDM foam compression pads are placed on top

Heritability of tic disorders: a twin-family study.

PubMed

Zilhão, N R; Olthof, M C; Smit, D J A; Cath, D C; Ligthart, L; Mathews, C A; Delucchi, K; Boomsma, D I; Dolan, C V

2017-04-01

Genetic-epidemiological studies that estimate the contributions of genetic factors to variation in tic symptoms are scarce. We estimated the extent to which genetic and environmental influences contribute to tics, employing various phenotypic definitions ranging between mild and severe symptomatology, in a large population-based adult twin-family sample. In an extended twin-family design, we analysed lifetime tic data reported by adult mono- and dizygotic twins (n = 8323) and their family members (n = 7164; parents and siblings) from 7311 families in the Netherlands Twin Register. We measured tics by the abbreviated version of the Schedule for Tourette and Other Behavioral Syndromes. Heritability was estimated by genetic structural equation modeling for four tic disorder definitions: three dichotomous and one trichotomous phenotype, characterized by increasingly strictly defined criteria. Prevalence rates of the different tic disorders in our sample varied between 0.3 and 4.5% depending on tic disorder definition. Tic frequencies decreased with increasing age. Heritability estimates varied between 0.25 and 0.37, depending on phenotypic definitions. None of the phenotypes showed evidence of assortative mating, effects of shared environment or non-additive genetic effects. Heritabilities of mild and severe tic phenotypes were estimated to be moderate. Overlapping confidence intervals of the heritability estimates suggest overlapping genetic liabilities between the various tic phenotypes. The most lenient phenotype (defined only by tic characteristics, excluding criteria B, C and D of DSM-IV) rendered sufficiently reliable heritability estimates. These findings have implications in phenotypic definitions for future genetic studies.

Heritability of Tic Disorders: a Twin-Family Study

PubMed Central

Zilhao, Nuno R.; Olthof, Maria C.; Smit, Dirk J.A.; Cath, Danielle C.; Ligthart, Lannie; Mathews, Carol A.; Delucchi, Kevin; Boomsma, Dorret I.; Dolan, Conor V.

2017-01-01

Background Genetic-epidemiological studies that estimate the contributions of genetic factors to variation in tic symptoms are scarce. We estimated the extent to which genetic and environmental influences contribute to tics, employing various phenotypic definitions ranging between mild and severe symptomatology, in a large population-based adult twin-family sample. Methods In an extended twin-family design, we analyzed lifetime tic data reported by adult mono- and dizygotic twins (n= 8,323) and their family members (n=7,164; parents and siblings) from 7,311 families in the Netherlands Twin Register (NTR). We measured tics by the abbreviated version of the Schedule for Tourette and Other Behavioral Syndromes (STOBS) (TSAICG, 2007). Heritability was estimated by genetic Structural Equation Modeling (SEM) for four tic disorder definitions: three dichotomous and one trichotomous phenotype, characterized by increasingly strictly defined criteria. Results Prevalence rates of the different tic disorders in our sample varied between 0.3 and 4.5% depending on tic disorder definition. Tic frequencies decreased with increasing age. Heritability estimates varied between .25 and .37, depending on phenotypic definitions. None of the phenotypes showed evidence of assortative mating, effects of shared environment, or non-additive genetic effects. Conclusions Heritabilities of mild and severe tic phenotypes were estimated to be moderate. Overlapping confidence intervals of the heritability estimates suggest overlapping genetic liabilities between the various tic phenotypes. The most lenient phenotype (defined only by tic characteristics, excluding criteria B, C and D of DSMIV) rendered sufficiently reliable heritability estimates. These findings have implications in phenotypic definitions for future genetic studies. PMID:27974054

Tics in the Pediatric Population: Pragmatic Management.

PubMed

Ganos, Christos; Martino, Davide; Pringsheim, Tamara

2017-01-01

Primary tic disorders, notably Tourette syndrome, are very common movement disorders in childhood. However, the management of such patients still poses great therapeutic challenges to medical professionals. Based on a synthesis of the available guidelines published in Europe, Canada, and the United States, coupled with more recent therapeutic developments, the authors provide a pragmatic guide to aid clinicians in deciding when and how to treat patients who have primary tic disorders. After a systematic assessment of tics and common neuropsychiatric comorbidities (primarily attention-deficit hyperactivity disorder [ADHD] and obsessive-compulsive disorder [OCD]), the first step in treatment is a comprehensive psychoeducation of patients and families that addresses the protean phenomenology of tics and associated behaviors, coping mechanisms, prognosis, and treatment options. When more active intervention beyond watchful monitoring is indicated, hierarchical evaluation of treatment targets (i.e., tics vs. comorbid behavioral symptoms) is crucial. Behavioral treatments for tics are restricted to older children and are not readily available to all centers, mainly due to the paucity of well-trained therapists. Pharmacological treatments, such as antipsychotics for tics, stimulants and atomoxetine for ADHD, and α2A-agonists for children with tics plus ADHD, represent widely available and effective treatment options, but safety monitoring must be provided. Combined polypharmacological and behavioral/pharmacological approaches, as well as neuromodulation strategies, remain under-investigated in this population of patients. The treatment of children with tics and Tourette syndrome is multifaceted. Multidisciplinary teams with expertise in neurology, psychiatry, psychology, and pediatrics may be helpful to address the complex needs of these children.

Improvisation in wrap-around toe-to-thumb transfer.

PubMed

Govila, A

1993-01-01

Wrap-around partial great toe transfer, a one time dream, is now a well established and universally accepted method of thumb reconstruction. In this technique, part of the soft tissue of the great toe are wrapped around and shaped to the size of the graft from iliac bone in such a manner that a thumb of normal dimensions and shape is produced. Instead of the iliac bone graft, we found great merit in using the second metacarpal from the traumatised hand to be reconstructed. In this paper its use and merits are elaborated.

Double second toe transfer in congenital hand anomalies.

PubMed

Van Holder, C; Giele, H; Gilbert, A

1999-08-01

A series of 14 patients with congenital hand anomalies who received staged double second toe transfers to the same hand for restoration of function or form were reviewed retrospectively. There were three children with constriction ring syndrome, two with symbrachydactyly and nine with transverse absence (failure of formation). There were different indications, technical difficulties and results with the various anomalies. All transferred toes were mobile and sensate, and were reported to be of benefit in both function and appearance. However, secondary surgical procedures were required in all patients.

TacSat-2: Path finder for a Close Space Support Asset

NASA Astrophysics Data System (ADS)

Bhopale, A.; Finley, C.

2008-08-01

With th e launch of TacSat-2, the Oper ationally Responsive Sp ace (O RS) commun ity had its f irst on- orbit asset and opportunity to prove or disprove the premise that small, in expensiv e, and quickly constructed spacecraf t could perform useful operation al missions when needed and for as long as need ed. All of the components of the comp lex TacSat-2 system had to work together to answer the basic questions, "In a crisis, can a lab-developed spacecraf t and ground architecture competen tly p erform th e mission of systems that cost twen ty times the price and tak e four times as long to develop? Mor eover, can th is system actu ally improve on the responsiveness of Nation al Systems to a certain set of underserv ed Oper ational customers?" When all w as said and done, TacSat-2 was a sp acecraf t that h ad to: 1) Carry th irteen tactical and scientific payloads to orbit, many of which doubled as essen tial, non-redundant subsystems; 2) Launch from an unproven launch base on a last minute "rep lacement" launch vehicle; and 3) Fulfill about 140 on-orbit mission requirements. It had tactical sensors, two unproven communication links, numerous next-gen eration single- string componen ts (e.g., h igh-efficiency propulsion system, thin-film so lar arrays, low-power versatile star camera) , and autonomous softw are to mak e the system more friendly and familiar to Tactical, rather than Spacecraf t Op erators. However, the mission was as mu ch about the implementation as it w as about the components. TacSat-2 was designed for and emp loyed with a different concept of operations ( CONOPS) than tradition al N ational Operational Assets. It w as designed to be th e fir st-ev er Clo se Space Support platform and operated in a manner more analogous to Close Air Support aircraf t than to tr aditional spacecraft. Therefore, th e primary objective of the TacSat-2 mission was to use th e TacSat-2 system to id entify those parts of the spacecr aft, ground system, and CON OPS

PILOT STUDY: THE TAMPA ASTHMATIC CHILDREN'S STUDY (TACS)

EPA Science Inventory

The Tampa Asthmatic Children's Study (TACS) was a pilot research study that focused on developing and evaluating air pollution exposure assessment methods and participant recruiting tools for children in the age range of 1-5 years old. The pilot study focused on (a) simple, cost-...

GUTs and TOEs

ScienceCinema

Lincoln, Don

2018-01-16

Albert Einstein said that what he wanted to know was “God’s thoughts,” which is a metaphor for the ultimate and most basic rules of the universe. Once known, all other phenomena would then be a consequence of these simple rules. While modern science is far from that goal, we have some thoughts on how this inquiry might unfold. In this video, Fermilab’s Dr. Don Lincoln tells what we know about GUTs (grand unified theories) and TOEs (theories of everything).

The Relation Between Attention and Tic Generation in Tourette Syndrome

PubMed Central

2014-01-01

Objective: Many neuropsychiatric disorders involve abnormal attentional processing. Systematic investigations of how attention may affect tic frequency in Tourette syndrome are lacking. Method: Patients performed rhythmic finger movements, approximately once every 2 s. Each movement triggered a unique visual color stimulus. Patients were asked to monitor and remember their finger actions, the external colors caused by their actions, or their tics. Sixteen adult Tourette syndrome patients performed each task twice: once while inhibiting tics, and once without inhibiting tics. Results: During the “freely tic” condition, patients had significantly fewer tics when attending to finger movements, or to the ensuing colors, compared with when attending to their tics. Attention to fingers produced the fewest tics overall. During tic suppression, tic frequency was reduced to an equal level in all conditions. Conclusions: Focusing attention away from tics significantly reduces tic frequency. This attentional process may operate by regulating motor noise. PMID:25486384

Neurodevelopment in preschool idiopathic toe-walkers.

PubMed

Martín-Casas, P; Ballestero-Pérez, R; Meneses-Monroy, A; Beneit-Montesinos, J V; Atín-Arratibel, M A; Portellano-Pérez, J A

2017-09-01

Idiopathic toe walking, a differential diagnosis for neurological and orthopaedic disorders, has been associated with neurodevelopmental alterations. Neurodevelopmental assessment at early ages using specific tests may improve management and follow-up of these patients. The aim of our study is to analyse the neurodevelopmental characteristics of preschool idiopathic toe-walkers (ITW) by comparing them to a control group. Our descriptive cross-sectional study compared possible risk factors, neurodevelopmental characteristics, and scores on the Child Neuropsychological Maturity Questionnaire (CUMANIN) between a group of 56 ITWs aged 3 to 6 and a control group including 40 children. The proportion of males was significantly higher in the ITW group (P=.008). The percentage of patients with a family history (P=.000) and biological risk factors during the perinatal period (P=.032) was also higher in this group. According to the parents' reports, motor coordination in ITWs was significantly poorer (59%; P=.009). ITWs scored significantly lower on CUMANIN subscales of psychomotricity (=0,001) and memory (P=.001), as well as in verbal development (P=.000), non-verbal development (P=.026), and overall development (P=.004). Foot preference was less marked in the ITW group (P=.047). The neurodevelopmental characteristics of our sample suggest that idiopathic toe walking is a marker of neurodevelopmental impairment. However, further studies are necessary to confirm these findings. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

Comparing fixed-amount and progressive-amount DRO Schedules for tic suppression in youth with chronic tic disorders.

PubMed

Capriotti, Matthew R; Turkel, Jennifer E; Johnson, Rachel A; Espil, Flint M; Woods, Douglas W

2017-01-01

Chronic tic disorders (CTDs) involve motor and/or vocal tics that often cause substantial distress and impairment. Differential reinforcement of other behavior (DRO) schedules of reinforcement produce robust, but incomplete, reductions in tic frequency in youth with CTDs; however, a more robust reduction may be needed to affect durable clinical change. Standard, fixed-amount DRO schedules have not commonly yielded such reductions, so we evaluated a novel, progressive-amount DRO schedule, based on its ability to facilitate sustained abstinence from functionally similar behaviors. Five youth with CTDs were exposed to periods of baseline, fixed-amount DRO (DRO-F), and progressive-amount DRO (DRO-P). Both DRO schedules produced decreases in tic rate and increases in intertic interval duration, but no systematic differences were seen between the two schedules on any dimension of tic occurrence. The DRO-F schedule was generally preferred to the DRO-P schedule. Possible procedural improvements and other future directions are discussed. © 2016 Society for the Experimental Analysis of Behavior.

Correlation between toe flexor strength and ankle dorsiflexion ROM during the countermovement jump.

PubMed

Yun, Sung Joon; Kim, Moon-Hwan; Weon, Jong-Hyuck; Kim, Young; Jung, Sung-Hoon; Kwon, Oh-Yun

2016-08-01

[Purpose] This study assessed the relationships between peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Subjects and Methods] Eighteen healthy volunteers participated in the study. Each participant completed tests for peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Results] The results showed (1) a moderate correlation between ankle dorsiflexion range of motion and countermovement jump height and (2) a high correlation between peak first toe flexor muscle strength and countermovement jump height. Peak first toe flexor muscle strength and ankle dorsiflexion range of motion are the main contributors to countermovement jump performance. [Conclusion] These findings indicate that the measurement of peak first toe flexor muscle strength and ankle dorsiflexion range of motion may be useful in clinical practice for improving jump performance in athletes training for sports such as volleyball and basketball.

The effects of Taraxacum officinale extracts (TOE) supplementation on physical fatigue in mice.

PubMed

Jinchun, Zhang; Jie, Chen

2011-01-01

The study is to investigate the effect of Taraxacum officinale extracts (TOE) supplementation on physical fatigue based on the forced swimming capacity in mice. Forty Kunming male mice were randomly divided into 4 groups, i.e., normal control (NC) and three doses of TOE treated group (High-dose, Middle-dose and Low-dose). Three TOE treated groups were treated by oral TOE with 10, 30 and 100mg/kg b.w respectively for a period of 42 days. The normal control group was given a corresponding volume of sterile distilled water. After 6 weeks, the forced swimming capacity and blood biochemical parameters in mice were measured, and the result showed that TOE had an anti- physical fatigue effect. It enhanced the maximum swimming capacity of mice, effectively delayed the lowering of glucose in the blood, and prevented the increase in lactate and triglyceride concentrations.

Clinical Assessment of Tourette Syndrome and Tic Disorders

PubMed Central

Cohen, Stephanie; Leckman, James F.; Bloch, Michael H.

2013-01-01

Tourette Syndrome (TS) is a neuropsychiatric disorder involving multiple motor and phonic tics. Tics, which usually begin between the ages of 6 and 8, are sudden, rapid, stereotyped, and apparently purposeless movements or sounds that involve discrete muscle groups. Individuals with TS experience a variety of different sensory phenomena, including premonitory urges prior to tics and somatic hypersensitivity due to impaired sensorimotor gating. In addition to other conditions, stress, anxiety, fatigue, or other heightened emotional states tend to exacerbate tics, while relaxation, playing sports, and focused concentration on a specific task tend to alleviate tic symptoms. Ninety percent of children with TS also have comorbid conditions, such as Attention deficit hyperactivity disorder (ADHD), Obsessive-compulsive disorder (OCD), or an impulse control disorder. These disorders often cause more problems for the child both at home and at school than tics do alone. Proper diagnosis and treatment of TS involves appropriate evaluation and recognition, not only of tics, but also of these associated conditions. PMID:23206664

Can Tics be Performed Convincingly by an Actor?

PubMed Central

Müller-Vahl, Kirsten R.; Riemann, Laura; Krämer, Hermann; Münchau, Alexander

2014-01-01

Background. In the German movie “Vincent will Meer” a healthy actor portrays a man with Tourette's syndrome. Objective. The aim of this study was to investigate whether the performance of tics is convincing and whether this judgment depends on whether he/she suffers from tics or not. Methods. While the movie was broadcasted in German cinemas, we put an online survey (including 28 questions on different aspects related to the observation, performance, and authenticity of tics) on the web pages of the German self-help group. 276/296 surveys submitted could be used for further analyses. Results. 95.7% of all participants felt that the performance of tics was convincing. However, people with tics (n = 26) were less convinced compared to those who had never met a person with tics (n = 110) (P = 0.020). Conclusions. Our results further support the hypothesis that tics are not “abnormal” but “physiological” movements that are only misplaced both in time and context. PMID:24895487

Can tics be performed convincingly by an actor?

PubMed

Müller-Vahl, Kirsten R; Riemann, Laura; Krämer, Hermann; Münchau, Alexander

2014-01-01

In the German movie "Vincent will Meer" a healthy actor portrays a man with Tourette's syndrome. Objective. The aim of this study was to investigate whether the performance of tics is convincing and whether this judgment depends on whether he/she suffers from tics or not. While the movie was broadcasted in German cinemas, we put an online survey (including 28 questions on different aspects related to the observation, performance, and authenticity of tics) on the web pages of the German self-help group. 276/296 surveys submitted could be used for further analyses. 95.7% of all participants felt that the performance of tics was convincing. However, people with tics (n = 26) were less convinced compared to those who had never met a person with tics (n = 110) (P = 0.020). Our results further support the hypothesis that tics are not "abnormal" but "physiological" movements that are only misplaced both in time and context.

Use of the Impact on Family Scale in Children with Tic Disorders: Descriptive Data, Validity, and Tic Severity Impact

ERIC Educational Resources Information Center

Woods, Douglas W.; Himle, Michael B.; Osmon, David C.

2005-01-01

Individuals with tic disorders are at risk for experiencing functional impairment in a variety of domains. However, the impact of tic disorders on family functioning remains unclear partly because psychometrically sound assessment instruments with normative data from a tic disorder population do not exist. The current study provides preliminary…

[Toe transplantation in congenital malformations of the hand].

PubMed

Foucher, G

1997-11-01

Toe transfer is a well established procedure for thumb and finger reconstruction after mutilation. The indications in congenital malformations are a mater of controversy. Out of a personal series of 209 patients, 42 were children presenting a congenital malformation. Thirty six, with 46 transfers were available for review. There is only one failure at the beginning of our experience. The main indication was absence of pinch either due to absence of thumb (like in congenital band syndrome or some extreme cases of ulnar club hand or cleft hand) or absence of long finger (like in symbrachydactyly monodactylous type) or lack of both thumb and finger (like in peromelic type of symbrachydactyly). In this last type, we have been disappointed by the functional result of the distal implantation of two second toes taken from both feet; we have proposed a "stub" operation consisting in a second toe transfer on the anterior aspect of the radial epiphysis to take advantage of the mobility of the wrist and the availability of plenty tendon transfer (in this proximal situation). When planing to "built" an absent pincer, an early age is mandatory for operation (mean 12 months), to ensure a good cortical integration. A less frequent indication is a partial toe transfer with a vascularized epiphysis to provide growth and mobility in some cases of thumb hypoplasia (like in symbrachydactyly or Blauth and Manske type III b). Results are difficult to assess due to the early operation but if the mobility has been disappointing (mean 32 degrees), sensibility (mean 2PD 5 mm) and growth were excellent.

Tics and psychiatric comorbidity in children and adolescents.

PubMed

Gadow, Kenneth D; Nolan, Edith E; Sprafkin, Joyce; Schwartz, Joseph

2002-05-01

This study examined comorbid psychiatric symptoms in a large, community-based sample of children and adolescents. The study sample comprised a total of 3006 school children: 413 preschool (3 to 5 years; 237 males, 176 females; mean age 4 years 2 months, SD 8 months), 1520 elementary school (5 to 12 years; 787 males, 733 females; mean age 8 years 2 months, SD 1 year 11 months), and 1073 secondary school children (12 to 18 years; 573 males, 500 females; mean age 14 years 4 months, SD 1 year 10 months), all of whom were attending regular education programs. Children were evaluated with a teacher-completed DSM-IV-referenced rating scale. The sample was divided into four groups: attention-deficit-hyperactivity disorder with tics (ADHD+tics), ADHD without tics (ADHD), tics without ADHD (T), and a comparison group i.e. neither ADHD nor tics (Non). The percentage of children with tic behaviors varied with age: preschool children (22.3%), elementary school children (7.8%), and adolescents (3.4%). Tic behaviors were more common in males than females, regardless of comorbid ADHD symptoms. For many psychiatric symptoms, screening prevalence rates were highest for the ADHD groups (ADHD+tics>ADHD>T>Non). However, obsessive-compulsive and simple and social phobia symptoms were more common in the groups with tic behavior. Findings for a community-based sample show many similarities with studies of clinically referred samples suggesting that teacher-completed ratings of DSM-IV symptoms may be a useful methodology for investigating the phenomenology of tic disorders.

Macintosh II based space Telemetry and Command (MacTac) system

NASA Technical Reports Server (NTRS)

Dominy, Carol T.; Chesney, James R.; Collins, Aaron S.; Kay, W. K.

1991-01-01

The general architecture and the principal functions of the Macintosh II based Telemetry and Command system, presently under development, are described, with attention given to custom telemetry cards, input/output interfaces, and the icon driven user interface. The MacTac is a low-cost, transportable, easy to use, compact system designed to meet the requirements specified by the Consultative Committeee for Space Data Systems while remaining flexible enough to support a wide variety of other user specific telemetry processing requirements, such as TDM data. In addition, the MacTac can accept or generate forward data (such as spacecraft commands), calculate and append a Polynomial Check Code, and output these data to NASCOM to provide full Telemetry and Command capability.

Effect of turf toe on foot contact pressures in professional American football players.

PubMed

Brophy, Robert H; Gamradt, Seth C; Ellis, Scott J; Barnes, Ronnie P; Rodeo, Scott A; Warren, Russell F; Hillstrom, Howard

2009-05-01

The relationship between turf toe and plantar foot pressures has not been extensively studied. Two hypotheses were tested in a cohort of professional American football players: first, that a history of turf toe is associated with increased peak hallucal and first metatarsophalangeal (MTP) plantar pressures; second, that decreased range of motion (ROM) of the first MTP correlates with increased peak hallucal and first MTP plantar pressures. Forty-four athletes from one National Football League (NFL) team were screened for a history of turf toe during preseason training. Dorsal passive MTP ROM and dynamic plantar pressures were measured in both feet of each player. Anatomical masking was used to assess peak pressure at the first MTP and hallux. First MTP dorsiflexion was significantly lower in halluces with a history of turf toe (40.6 +/- 15.1 degrees versus 48.4 +/- 12.8 degrees, p = 0.04). Peak hallucal pressures were higher in athletes with turf toe (535 +/- 288 kPa versus 414 +/- 202 kPa, p = 0.05) even after normalizing for athlete body mass index (p = 0.0003). Peak MTP pressure was not significantly different between the two groups tested. First MTP dorsiflexion did not correlate with peak hallucal or first MTP pressures. This study showed that turf toe is associated with decreased MTP motion. In addition, increased peak hallucal pressures were found. Further study is warranted to determine whether these pressures correlate with the severity of symptoms or progression of turf toe to first MTP arthritis.

Assessment of leg muscle activity using toe tapping in patients with Parkinson's disease: comparison of two types of toe tapping.

PubMed

Taniguchi, Seira; Peper, Ferdinand; Shimokawa, Tetsuya

2018-05-01

[Purpose] This study investigates two types of toe tapping, i.e., "closed," with both feet on the floor, and "open," in which the foot does not touch the ground, and evaluates their usefulness in combination with monitoring of muscle activity during toe tapping. [Subjects and Methods] The study enrolled 11 patients with Parkinson's disease (PD) and 9 controls (Controls). The tibialis anterior (TA) and gastrocnemius (GS) muscle activity during toe tapping was measured using surface electromyography. [Results] In closed tapping, the minima in GS activation with the first tap was significantly higher in patients with PD than in Controls. In open tapping, the coefficient of variation (CV) of local maxima in TA activation was significantly higher in patients with PD than in Controls. In both types of tapping, the CV of extrema in GS activities increased with disease duration, but this may be due to the long-term administration of Levodopa, which itself tends to cause excessive GS activities. [Conclusion] Closed tapping is suitable for the assessment of GS activity and can detect excessive activities, which is observed as visible movement. Open tapping, on the other hand, is suitable for assessment of TA activity.

Tic symptom dimensions and their heritabilities in Tourette's syndrome.

PubMed

de Haan, Marcel J; Delucchi, Kevin L; Mathews, Carol M; Cath, Danielle C

2015-06-01

Gilles de la Tourette's syndrome (TS) is both genotypically and phenotypically heterogeneous. Gene-finding strategies have had limited success, possibly because of symptom heterogeneity. This study aimed at specifically investigating heritabilities of tic symptom factors in a relatively large sample of TS patients and family members. Lifetime tic symptom data were collected in 494 diagnosed individuals in two cohorts of TS patients from the USA (n=273) and the Netherlands (n=221), and in 351 Dutch family members. Item-level factor analysis, using a tetrachoric correlation matrix in SAS (v9.2), was carried out on 23 tic symptoms from the Yale Global Tic Severity Scale. Three factors were identified explaining 49% of the total variance: factor 1, complex vocal tics and obscene behaviour; factor 2, body tics; and factor 3, head/neck tics. Using Sequential Oligogenic Linkage Analysis Routine, moderate heritabilities were found for factor 1 (h2r=0.21) and factor 3 (h2r=0.25). Lower heritability was found for overall tic severity (h2r=0.19). Bivariate analyses indicated no genetic associations between tic factors. These findings suggest that (i) three tic factors can be discerned with a distinct underlying genetic architecture and that (ii) considering the low tic heritabilities found, only focusing on the narrow-sense TS phenotype and leaving out comorbidities that are part of the broader sense tic phenotype may lead to missing heritability. Although these findings need replication in larger independent samples, they might have consequences for future genetic studies in TS.

Nail tic disorders: Manifestations, pathogenesis and management.

PubMed

Singal, Archana; Daulatabad, Deepashree

2017-01-01

Nail tic disorders are classic examples of overlap between the domains of dermatology and psychiatry. They are examples of body-focused repetitive behaviors in which there is an irresistible urge or impulse to perform a certain behavior. The behavior is reinforced as it results in some degree of relief and pleasure. Nail tic disorders are common, yet poorly studied and understood. The literature on nail tic disorders is relatively scarce. Common nail tics include nail biting or onychophagia, onychotillomania and the habit tic deformity. Some uncommon and rare nail tic disorders are onychoteiromania, onychotemnomania, onychodaknomania and bidet nails. Onychophagia is chronic nail biting behavior which usually starts during childhood. It is often regarded as a tension reducing measure. Onychotillomania is recurrent picking and manicuring of the fingernails and/or toenails. In severe cases, it may lead to onychoatrophy due to irreversible scarring of the nail matrix. Very often, they occur in psychologically normal children but may sometimes be associated with anxiety. In severe cases, onychotillomania may be an expression of obsessive-compulsive disorders. Management of nail tic disorders is challenging. Frequent applications of distasteful topical preparations on the nail and periungual skin can discourage patients from biting and chewing their fingernails. Habit-tic deformity can be helped by bandaging the digit daily with permeable adhesive tape. Fluoxetine in high doses can be helpful in interrupting these compulsive disorders in adults. For a complete diagnosis and accurate management, it is imperative to assess the patient's mental health and simultaneously treat the underlying psychiatric comorbidity, if any.

Initial Psychometric Properties of a Brief Parent-Report Instrument for Assessing Tic Severity in Children with Chronic Tic Disorders

ERIC Educational Resources Information Center

Chang, Susanna; Himle, Michael B.; Tucker, Benjamin T. P.; Woods, Douglas W.; Piacentini, John

2009-01-01

This article describes the development and initial psychometric properties of the Parent Tic Questionnaire (PTQ)--a new measure assessing the number, frequency, and intensity of motor and vocal tics in children and adolescents with Chronic Tic Disorder (CTD). Parents of 40 children with a CTD completed the PTQ as part of a larger assessment…

The miR172 target TOE3 represses AGAMOUS expression during Arabidopsis floral patterning.

PubMed

Jung, Jae-Hoon; Lee, Sangmin; Yun, Ju; Lee, Minyoung; Park, Chung-Mo

2014-02-01

microRNA172 (miR172) regulates phase transition and floral patterning in Arabidopsis by repressing targets that encode the APETALA2 (AP2) and AP2-like transcription factors. The miR172-mediated repression of the AP2 gene restricts AGAMOUS (AG) expression. In addition, most miR172 targets, including AP2, redundantly act as floral repressors, and the overexpression of the target genes causes delayed flowering. However, how miR172 targets other than AP2 regulate both of the developmental processes remains unclear. Here, we demonstrate that miR172-mediated repression of the TARGET OF EAT 3 (TOE3) gene is critical for floral patterning in Arabidopsis. Transgenic plants that overexpress a miR172-resistant TOE3 gene (rTOE3-ox) exhibit indeterminate flowers with numerous stamens and carpelloid organs, which is consistent with previous observations in transgenic plants that overexpress a miR172-resistant AP2 gene. TOE3 binds to the second intron of the AG gene. Accordingly, AG expression is significantly reduced in rTOE3-ox plants. TOE3 also interacts with AP2 in the nucleus. Given the major role of AP2 in floral patterning, miR172 likely regulates TOE3 in floral patterning, at least in part via AP2. In addition, a miR156 target SQUAMOSA PROMOTER BINDING PROTEIN-LIKE 3 directly activates TOE3 expression, revealing a novel signaling interaction between miR156 and miR172 in floral patterning. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Self-esteem in adults with Tourette syndrome and chronic tic disorders: The roles of tic severity, treatment, and comorbidity.

PubMed

Weingarden, Hilary; Scahill, Lawrence; Hoeppner, Susanne; Peterson, Alan L; Woods, Douglas W; Walkup, John T; Piacentini, John; Wilhelm, Sabine

2018-07-01

Tourette syndrome (TS) and chronic tic disorders (CTD) are stigmatizing disorders that may significantly impact self-esteem. Alternatively, comorbid psychiatric illnesses may affect self-esteem more than tics themselves. Extant research on self-esteem in TS/CTD is limited, has inconsistently examined the effect of comorbidities on self-esteem, and yields mixed findings. This study aimed to clarify the roles of tics versus comorbid diagnoses on self-esteem in a large, carefully diagnosed sample of adults with TS/CTD (N = 122) receiving 10 weeks of Comprehensive Behavioral Intervention for Tics (CBIT) or Psychoeducation and Supportive Therapy (PST). Baseline self-esteem did not differ between adults with TS/CTD only and normative means, whereas self-esteem was significantly lower among adults with TS/CTD with a comorbid psychiatric illness. In a multiple regression testing the baseline association between tic severity, presence of comorbid psychiatric illness, and depression severity with self-esteem, comorbidity and depression severity were significantly associated with self-esteem, whereas tic severity was not. Finally, using a generalized linear model, we tested the effects of treatment assignment, comorbidity, and their interaction on changes in self-esteem across treatment, controlling for baseline depression severity. Results showed that for those with a comorbid illness, self-esteem improved significantly more with CBIT than with PST. Comorbid illnesses appear to affect self-esteem more so than tics among adults with TS/CTD. Therapeutic attention should be paid to treating comorbid diagnoses alongside tics when treating TS/CTD. Copyright © 2018 Elsevier Inc. All rights reserved.

Therapeutic Developments for Tics and Myoclonus.

PubMed

Jankovic, Joseph

2015-09-15

Tics and myoclonus are phenomenologically similar given that both are jerk-like movements, but, in contrast to myoclonus, tics are often preceded by premonitory sensations and are typically associated with a variety of behavioral comorbidities, including attention deficit and obsessive-compulsive disorder. There are many other clinical features that help differentiate these two hyperkinetic disorders. Whereas behavioral and antidopaminergic therapies are most effective in the management of tics, clonazepam, other anticonvulsants, and serotonergic drugs are often used to control myoclonic movements. Botulinum toxin may also be helpful in focal tics and in segmental forms of myoclonus. DBS plays an increasingly important role in the treatment of these disorders, particularly when they are generalized and are disabling despite optimal medical therapy. © 2015 International Parkinson and Movement Disorder Society.

New onset of idiopathic bilateral ear tics in an adult.

PubMed

Agrawal, Amit; Shrestha, Rabin

2009-04-01

Tic disorders are commonly considered to be childhood syndromes. Newly presenting tic disorders during adulthood are uncommon and mostly described in relation to an acquired brain lesion or as incidental tics, particularly in context with other neurological or psychiatric diseases. Tic disorder involving the ears is extremely uncommon with only few studies in English literature. In the present case, we describe an adult patient with new-onset idiopathic tics disorder involving both ears, causing social embarrassment. In addition, our patient had recent onset of the tics without any childhood or family history of tic disorders. The single most important component of management is an accurate diagnosis. At the same time, tics should be differentiated from other movement disorders such as chorea, stereotypy, and dystonias.

Increased healing in diabetic toe ulcers in a multidisciplinary foot clinic-An observational cohort study.

PubMed

Almdal, T; Nielsen, A Anker; Nielsen, K E; Jørgensen, M E; Rasmussen, A; Hangaard, S; Siersma, V; Holstein, P E

2015-12-01

To study toe ulcer healing in patients with diabetic foot ulcers attending a multidisciplinary foot clinic over a 10 years period. The study was retrospective, consecutive and observational during 2001 through 2011. The patients were treated according to the International Consensus on the Diabetic Foot. During the period the chiropodist staffing in the foot clinic was doubled; new offloading material and orthopedic foot corrections for recalcitrant ulcers were introduced. Healing was investigated in toe ulcers in Cox regression models. 2634 patients developed foot ulcers, of which 1461 developed toe ulcers; in 790 patients these were neuropathic, in 551 they were neuro-ischemic and in 120 they were critically ischemic. One-year healing rates increased in the period 2001-2011 from 75% to 91% for neuropathic toe ulcers and from 72% to 80% for neuro-ischemic toe ulcers, while no changes was observed for ischemic toe ulcers. Adjusted for changes in the patient population, the overall rate of healing for neuropathic and neuro-ischemic toe ulcers almost doubled (HR=1.95 [95% CI: 1.36-2.80]). The results show that the healing of toe ulcers improved. This outcome could not be explained by changes in the patient characteristics, but coincided with a number of improvements in organization and therapy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A Two-Step Integrated Theory of Everything (TOE)

NASA Astrophysics Data System (ADS)

Colella, Antonio

2017-01-01

Two opposing TOE visions are my Two-Step (physics/math) and Hawking's single math step. My Two-Step should replace the single step because of the latter's near zero results after a century of attempts. My physics step had 3 goals. First ``Everything'' was defined as 20 interrelated amplified theories (e.g. string, Higgs forces, spontaneous symmetry breaking, particle decays, dark matter, dark energy, stellar black holes) and their intimate physical interrelationships. Amplifications of Higgs forces theory (e.g. matter particles and their associated Higgs forces were one and inseparable, spontaneous symmetry breaking was bidirectional and caused by high temperatures not Higgs forces, and sum of 8 Higgs forces of 8 permanent matter particles was dark energy) were key to my Two-Step TOE. The second goal answered all outstanding physics questions: what were Higgs forces, dark energy, dark matter, stellar black holes, our universe's creation, etc.? The third goal provided correct inputs for the two part second math step, an E8 Lie algebra for particles and an N-body cosmology simulation (work in progress). Scientific advancement occurs only if the two opposing TOEs are openly discussed/debated.

Five- and 10-Year Follow-Up of Nonvascularized Toe Phalanx Transfers.

PubMed

Kawabata, Hidehiko; Tamura, Daisuke

2018-05-01

The purpose of this study was to evaluate long-term outcomes of nonvascularized toe phalanx transfer. We retrospectively reviewed 54 nonvascularized toe phalanx transfers in 29 children with symbrachydactyly. Forty-seven transfers in 24 children were evaluated at 5-year follow-up and 27 transfers in 14 children were evaluated at 10-year follow-up. We recorded the incidence of the early physeal closure and the length of the transferred toe phalanx on plain radiographs at 5- and 10-year follow-up. Growth rate in the first 5 years and the following 5 years were calculated. Function of the metacarpophalangeal joint (motion, stability, and alignment) was also evaluated. The mean age at surgery was 1.5 years. Seven toe phalanges were trimmed because the skin pocket was tight. Five transfers required revision surgery for partial necrosis of the skin pocket. At 5-year follow-up, the physis was closed in 23%, and at 10 years, 78% of physes were closed. The phalanx length was 87% of expected at 5-year follow-up and 71% at 10-year follow-up. Growth rate was 0.83 mm/y in the first 5 years and 0.22 mm/y in the following 5 years. Active motion was rated as good in 24, fair in 7, and poor in 16. Stability and alignment were rated as good in 37 and 33, fair in 8 and 5, and poor in 2 and 9, respectively. Nonvascularized toe phalanx transfer offered a relatively simple method to lengthen short digits and to provide satisfactory function. The transferred toe phalanges grew at a near-normal rate in the first 5 years, but the growth rate decreased between 5 and 10 years. Therapeutic IV. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Susceptibility and remanence studies in the quasi-1D mixed ferromagnet CoTAC : Mn

NASA Astrophysics Data System (ADS)

Cheikhrouhou, A.; Dupas, C.; Renard, J. P.; Veillet, P.

1985-03-01

The ac susceptibility and dc magnetization of CoTAC : Mn ((CH 3) 3NHCo 1- xMn xCl 3ṡ2H 2O) have been studied in the temperature range 1.3-4.2 K on two monocrystalline samples with x = 2.9 and 9.3%. In CoTAC : Mn (9.3%), the variation with the measuring frequency ν of the temperature of the susceptibility maximum Tg(ν) is well described over five decades of frequency by an Arrhenius law Tg-1(ν) = a - b log ν characteristic of superparamagnetic clusters. In CoTAC : Mn (2.9%) Tg(ν) does not differ significantly from that of pure CoTAC. Both compounds exhibit strong remanence effects below Tg. The variations with time, temperature and applied magnetic field of the IRM and TRM are similar to those observed in spin glasses. These experiments confirm the onset of spin-glass-like behaviour or superparamagnetism in quasi-1D insulators with random intrachain exchange at very low impurity concentration. Comparison with the previously studied mixed compound CHAC : Mn evidences the influence of the exchange anisotropy on the static properties of these systems.

Severe stuttering and motor tics responsive to cocaine.

PubMed

Linazasoro, G; Van Blercom, N

2007-02-01

Developmental stuttering and tics share many clinical and therapeutical aspects. Dopaminergic neurotransmission seems to be involved in the pathophysiology of both, tics and stuttering. We report on a patient with severe stuttering and mild facial tics which were dramatically improved by cocaine, challenging previous reports.

A prototype wireless inertial-sensing device for measuring toe clearance.

PubMed

Lai, Daniel T H; Charry, E; Begg, R; Palaniswami, M

2008-01-01

Tripping and slipping are serious health concerns for the elderly because they result in life threatening injuries i.e., fractures and high medical costs. Our recent work in detection of tripping gait patterns has demonstrated that minimum toe clearance (MTC) is a sensitive falls risk predictor. MTC measurement has previously been done in gait laboratories and on treadmills which potentially imposes controlled walking conditions. In this paper, we describe a prototype design of a wireless device for monitoring vertical toe clearance. The sensors consists of a tri-axis accelerometer and dual-axis gyroscope connected to Crossbow sensor motes for wireless data transmission. Sensor data are transmitted to a laptop and displayed on a Matlab graphic user interface (GUI). We have performed zero base and treadmill experiments to investigate sensor performance to environmental variations and compared the calculated toe clearance against measurements made by an Optotrak motion system. It was found that device outputs were approximately independent of small ambient temperature variations, had a reliable range of 20m indoors and 50m outdoors and a maximum transmission rate of 20 packets/s. Toe clearance measurements were found to follow the Optotrak measurement trend but could be improved further by dealing with double integration errors and improving data transmission rates.

The future of tic disorder treatment.

PubMed

Bennett, Shannon M; Keller, Alex E; Walkup, John T

2013-11-01

Competing theories on the etiology and treatment of chronic tic disorders and Tourette syndrome have long made the search for efficacious intervention more challenging for patients and families seeking to reduce functional impairment related to tic symptoms. These symptoms were historically posited to be either psychological in origin, leading to the long tradition of psychoanalytic psychotherapy for tics, or biological in nature, particularly since the advent of successful treatments using neuroleptic medications. Current thinking about the phenomenology of tic disorders comes from growing empirical evidence as well as advances in neuroscience and genetics research and reveals a biological vulnerability that is exacerbated by physiological arousal related to environmental or interpersonal stress. This manuscript summarizes the evolution of this knowledge base and describes current best-practice recommendations for patients, families, and clinicians. © 2013 New York Academy of Sciences.

Premonitory Urge for Tics Scale (PUTS): replication and extension of psychometric properties in youth with chronic tic disorders (CTDs).

PubMed

Raines, Jeremy M; Edwards, Kimberly R; Sherman, Martin F; Higginson, Christopher I; Winnick, Joel B; Navin, Kelly; Gettings, Julie M; Conteh, Fatmata; Bennett, Shannon M; Specht, Matthew W

2018-04-01

Individuals with chronic tic disorders (CTDs) frequently describe aversive subjective sensory sensations that precede their tics. The first aim of the present study was to explore the psychometric properties of a standardized self-report measure to assess premonitory urges in CTDs, The Premonitory Urge for Tics Scale (PUTS), by replicating the analyses of Woods et al. (J Dev Behav Pediatr 26:397-403, 2005) using a sample twice the size of theirs. The second aim was to conduct an exploratory factor analysis of the PUTS. Eighty-four youth with CTDs, recruited from a pediatric OCD and tic specialty clinic, completed the PUTS while their caregivers completed The Parent Tic Questionnaire (PTQ) and a demographic measure. Consistent with (Woods et al. J Dev Behav Pediatr 26:397-403, 2005), the PUTS was found to be internally consistent (α = 0.82) and significantly correlated with overall tic severity as measured by the PTQ (r = 0.24, p < 0.05) as well as the PTQ number (r = 0.34, p < 0.01) and intensity (r = 0.24, p < 0.05) subscales. A factor-analysis of the PUTS revealed a two-factor solution with one factor capturing the quality of premonitory sensations while the other factor assessed the overall intensity of the urges. These results support the use of the PUTS in reliably measuring premonitory urges, particularly in children over the age of 10 years. Additionally, these findings highlight that urges are uniformly reported across gender and age and are more closely associated with number of tics than the frequency or intensity of tics.

Rupture of the extensor hood of the fifth toe: a rare injury.

PubMed

Venturini, Sara; Gaba, Suchi; Mangwani, Jitendra

2017-02-27

Closed injuries of the extensor hood of the lesser toes are rare and seldom reported in the literature. We present the case of a woman aged 25 years who presented to the orthopaedic fracture clinic with a 2-week history of pain in the left fifth toe and inability to extend following a ballet dancing session. Investigations showed no fracture on plain radiographs, but an ultrasound scan demonstrated rupture to the extensor hood of the little toe. Successful surgical repair of the extensor hood was performed, and the patient made a good recovery with return to dancing activities. 2017 BMJ Publishing Group Ltd.

Motor tics evoked by striatal disinhibition in the rat

PubMed Central

Bronfeld, Maya; Yael, Dorin; Belelovsky, Katya; Bar-Gad, Izhar

2013-01-01

Motor tics are sudden, brief, repetitive movements that constitute the main symptom of Tourette syndrome (TS). Multiple lines of evidence suggest the involvement of the cortico-basal ganglia system, and in particular the basal ganglia input structure—the striatum in tic formation. The striatum receives somatotopically organized cortical projections and contains an internal GABAergic network of interneurons and projection neurons' collaterals. Disruption of local striatal GABAergic connectivity has been associated with TS and was found to induce abnormal movements in model animals. We have previously described the behavioral and neurophysiological characteristics of motor tics induced in monkeys by local striatal microinjections of the GABAA antagonist bicuculline. In the current study we explored the abnormal movements induced by a similar manipulation in freely moving rats. We targeted microinjections to different parts of the dorsal striatum, and examined the effects of this manipulation on the induced tic properties, such as latency, duration, and somatic localization. Tics induced by striatal disinhibition in monkeys and rats shared multiple properties: tics began within several minutes after microinjection, were expressed solely in the contralateral side, and waxed and waned around a mean inter-tic interval of 1–4 s. A clear somatotopic organization was observed only in rats, where injections to the anterior or posterior striatum led to tics in the forelimb or hindlimb areas, respectively. These results suggest that striatal disinhibition in the rat may be used to model motor tics such as observed in TS. Establishing this reliable and accessible animal model could facilitate the study of the neural mechanisms underlying motor tics, and the testing of potential therapies for tic disorders. PMID:24065893

C-TIC Console Operator's User Manual

DOT National Transportation Integrated Search

1996-07-01

The C-TIC Console Operator's User Manual is designed to assist the operator at : the Corridor Transportation Information Center with the navigation and use of : the application programs in the C-TIC. This document will concentrate solely on : the ext...

Repair of webbed fingers or toes

MedlinePlus

... Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team. Finger Injuries and Disorders Read more Toe Injuries ...

Solar Technology Acceleration Center (SolarTAC): Solar Resource & Meteorological Assessment Project (SOLRAMP)

DOE Data Explorer

Andreas, Afshin; Wilcox, Steve

2016-03-14

Located in Colorado, near Denver International Airport, SolarTAC is a private, member-based, 74-acre outdoor facility where the solar industry tests, validates, and demonstrates advanced solar technologies. SolarTAC was launched in 2008 by a public-private consortium, including Midwest Research Institute (MRI). As a supporting member of SolarTAC, the U.S. Department of Energy National Renewable Energy Laboratory (NMREL) has established a high quality solar and meteorological measurement station at this location. This Solar Resource and Meteorological Assessment Project (SOLRMAP) provides high quality measurements to support deployment of power projects in the United States. The no-funds-exchanged collaboration brings NREL solar resource assessment expertise together with industry needs for measurements. The end result is high quality data sets to support the financing, design, and monitoring of large scale solar powered projects for industry in addition to research-quality data for NREL model development. NREL provides consultation for instrumentation and station deployment, along with instrument calibrations, data acquisition, quality assessment, data distribution, and summary reports. Industry participants provide equipment, infrastructure, and station maintenance.

Flexor digitorum brevis transfer for floating toe prevention after Weil osteotomy: a cadaveric study.

PubMed

Lee, Lydia C; Charlton, Timothy P; Thordarson, David B

2013-12-01

A floating toe deformity occurs in many patients who undergo Weil osteotomies. It is likely caused by the failure of the windlass mechanism in shortening the metatarsal. For patients who require a proximal interphalangeal (PIP) joint arthroplasty or fusion in addition to a Weil osteotomy, the transfer of the flexor digitorum brevis (FDB) tendon to the PIP joint might restore the windlass mechanism and decrease the incidence of floating toes. Fourteen cadaveric foot specimens were examined to determine the effects of changing metatarsal length as well as tensioning the FDB tendon on the angle of the metatarsophalangeal (MTP) joint as a measure of a floating toe. Shortening and lengthening the second metatarsal resulted in a significant change in MTP angle (P = .03 and .02, respectively), though there was no clear relationship found between the amount of change in metatarsal length and the change in MTP angle. Transferring the FDB to a PIP arthroplasty site plantarflexed the MTP joint and corrected floating toes; the change in angle was significant compared with the control and shortening groups (P = .0001 and .002, respectively). This study supports the theory that change in length of the metatarsal, possibly via the windlass mechanism, plays a role in the pathophysiology of the floating toe deformity. Tensioning and transferring the FDB tendon into the PIP joint helped prevent the floating toe deformity in this cadaveric model. Continued research in this subject will help to refine methods of prevention and correction of the floating toe deformity.

50 CFR 665.211 - Total Allowable Catch (TAC) limit.

Code of Federal Regulations, 2014 CFR

2014-10-01

... 50 Wildlife and Fisheries 13 2014-10-01 2014-10-01 false Total Allowable Catch (TAC) limit. 665.211 Section 665.211 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES IN THE WESTERN PACIFIC Hawaii...

50 CFR 665.211 - Total Allowable Catch (TAC) limit.

Code of Federal Regulations, 2012 CFR

2012-10-01

... 50 Wildlife and Fisheries 13 2012-10-01 2012-10-01 false Total Allowable Catch (TAC) limit. 665.211 Section 665.211 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES IN THE WESTERN PACIFIC Hawaii...

50 CFR 665.211 - Total Allowable Catch (TAC) limit.

Code of Federal Regulations, 2013 CFR

2013-10-01

... 50 Wildlife and Fisheries 13 2013-10-01 2013-10-01 false Total Allowable Catch (TAC) limit. 665.211 Section 665.211 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES IN THE WESTERN PACIFIC Hawaii...

50 CFR 665.211 - Total Allowable Catch (TAC) limit.

Code of Federal Regulations, 2010 CFR

2010-10-01

... 50 Wildlife and Fisheries 9 2010-10-01 2010-10-01 false Total Allowable Catch (TAC) limit. 665.211 Section 665.211 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES IN THE WESTERN PACIFIC Hawaii...

50 CFR 665.211 - Total Allowable Catch (TAC) limit.

Code of Federal Regulations, 2011 CFR

2011-10-01

... 50 Wildlife and Fisheries 11 2011-10-01 2011-10-01 false Total Allowable Catch (TAC) limit. 665.211 Section 665.211 Wildlife and Fisheries FISHERY CONSERVATION AND MANAGEMENT, NATIONAL OCEANIC AND ATMOSPHERIC ADMINISTRATION, DEPARTMENT OF COMMERCE (CONTINUED) FISHERIES IN THE WESTERN PACIFIC Hawaii...

Tics and other stereotyped movements as side effects of pharmacological treatment.

PubMed

Madruga-Garrido, Marcos; Mir, Pablo

2013-01-01

Tics and other stereotyped abnormal movements can be seen as adverse effects of some pharmacologic drugs. Among these drugs, antipsychotics may provoke tardive syndromes after a chronic exposure, primarily in the case of typical antipsychotics. These syndromes include tardive tics, tardive dyskinesia, or tardive akathisia, which present with tics or stereotyped movements as a clinical phenomenon. Psychostimulants (mainly methylphenidate) have traditionally been associated with the appearance of tics due to the increased dopamine activity caused by stimulants. Nevertheless, in recent years, several studies have concluded not only that methylphenidate does not exacerbate or reactivate tics but also that tics can improve with its use in patients with associated attention deficit and hyperactivity disorder and tic disorder. Antiepileptic drugs, although infrequently, can also induce tics, with carbamazepine and lamotrigine described as tic inducers. Other antiepileptics, including levetiracetam and topiramate, have been proposed as a potential treatment for tic disorders due to a positive effect on tics, especially in those with associated epileptic disorder. Clinical and therapeutic approaches to tics and stereotyped movements after exposure to antipsychotics, stimulants, and antiepileptic drugs will be reviewed in this chapter. © 2013 Elsevier Inc. All rights reserved.

Effects of Speed and Visual-Target Distance on Toe Trajectory During the Swing Phase of Treadmill Walking

NASA Technical Reports Server (NTRS)

Miller, Christopher A.; Feiveson, Al; Bloomberg, Jacob J.

2007-01-01

Toe trajectory during swing phase is a precise motor control task that can provide insights into the sensorimotor control of the legs. The purpose of this study was to determine changes in vertical toe trajectory during treadmill walking due to changes in walking speed and target distance. For each trial, subjects walked on a treadmill at one of five speeds while performing a dynamic visual acuity task at either a far or near target distance (five speeds two targets distances = ten trials). Toe clearance decreased with increasing speed, and the vertical toe peak just before heel strike increased with increasing speed, regardless of target distance. The vertical toe peak just after toe-off was lower during near-target visual acuity tasks than during far-target tasks, but was not affected by speed. The ankle of the swing leg appeared to be the main joint angle that significantly affected all three toe trajectory events. The foot angle of the swing leg significantly affected toe clearance and the toe peak just before heel strike. These results will be used to enhance the analysis of lower limb kinematics during the sensorimotor treadmill testing, where differing speeds and/or visual target distances may be used.

Toe spatiotemporal differences between transition steps when ascending shorter flight stairways of different heights.

PubMed

Ajisafe, Toyin; Wu, Jianhua; Geil, Mark

2017-03-01

Studies have typically treated the first and second floor-to-stair transition steps (TS1 and TS2) as one stride. However, because the foot is devoid of plantar cutaneous input from the stair surface at TS1, these steps may have different toe spatiotemporal profiles, and resultantly, different susceptibilities to a trip and/or a fall. This study compared vertical toe clearance, forward velocity, and their respective variability magnitudes between TS1 and TS2 when ascending stairs of different heights. Twenty young adults (seven males and 13 females) (21.68 ± 2.49 years; 169.70 ± 9.56 cm; 63.91 ± 9.62 kg) negotiated an intervening three-step staircase placed midpoint on a 10 m walkway. There were three stair heights: low stairs (LS), medium stairs (MS), and high stairs (HS). Vertical toe clearance, forward velocity, and their variability magnitudes were calculated. Vertical toe clearance was only higher (P < 0.05) at TS1 than TS2 in the medium and high stairs. Vertical toe clearance was more variable (P < 0.05) in the low compared to medium stairs. Also, forward toe velocity was greater at TS1 than TS2, but was lower in the medium and high stairs. The locomotor system appeared cautious by exaggerating vertical toe clearance at both TS1 and TS2 only in low stairs, possibly due to higher forward toe velocity. If the exaggeration strategy consistently persists, this finding may suggest decreased trip or fall risk at both TS1 and TS2 only when transitioning onto low stairs. Copyright © 2016 Elsevier Ltd. All rights reserved.

Abdominal X-ray signs of intra-intestinal drug smuggling.

PubMed

Niewiarowski, Sylwia; Gogbashian, Andrew; Afaq, Asim; Kantor, Robin; Win, Zarni

2010-05-01

"Body packers" either swallow or insert drug filled packets rectally or vaginally in order to smuggle illicit drugs. AXR is used routinely to screen suspects for the presence of intra-intestinal drug packages. AXR diagnosis can be difficult as stool or gas within the intestine may resemble ingested foreign bodies. We identify the frequency and co-existence of several signs; tic-tac sign, rosette sign, double condom sign, dense surrounding material, density and discover a new sign; parallelism, which will aid in increasing the radiological accuracy. We retrospectively reviewed 285 AXRs performed for suspicion of drug smuggling during the period of March 2006-March 2009 to identify the frequency of these signs. Of the 285 AXRs performed 59 were positive, 221 negative and five were indeterminate. The tic-tac sign was present in 93%, double condom sign in 73%, dense surrounding wrapping material in 36% and parallelism in 27%. Sixty one percentage of drug packages were iso-dense to faeces and 39% hyperdense. Twenty percentage of the positive abdominal radiographs demonstrated one of the radiographic signs, 39% demonstrated two signs, 32% demonstrated three and 7% four. The most common radiographic sign combination was the tic-tac sign with either dense surrounding material or double condom sign. The most commonly encountered radiographic sign is the tic-tac sign, followed by the double condom sign and dense surrounding material. We also discover a new sign, "parallelism" which although uncommon is highly specific. Accuracy is further increased by comparing the density of packages to faeces and looking for the co-existence of multiple signs. Copyright (c) 2010 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

Non-MTC gait cycles: An adaptive toe trajectory control strategy in older adults.

PubMed

Santhiranayagam, Braveena K; Sparrow, W A; Lai, Daniel T H; Begg, Rezaul K

2017-03-01

Minimum-toe-clearance (MTC) above the walking surface is a critical representation of toe-trajectory control due to its association with tripping risk. Not all gait cycles exhibit a clearly defined MTC within the swing phase but there have been few previous accounts of the biomechanical characteristics of non-MTC gait cycles. The present report investigated the within-subject non-MTC gait cycle characteristics of 15 older adults (mean 73.1 years) and 15 young controls (mean 26.1 years). Participants performed the following tasks on a motorized treadmill: preferred speed walking, dual task walking (carrying a glass of water) and a dual-task speed-matched control. Toe position-time coordinates were acquired using a 3 dimensional motion capture system. When MTC was present, toe height at MTC (MTC height ) was extracted. The proportion of non-MTC gait cycles was computed for the age groups and individuals. For non-MTC gait cycles an 'indicative' toe height at the individual's average swing phase time (MTC time ) for observed MTC cycles was averaged across multiple non-MTC gait cycles. In preferred-speed walking Young demonstrated 2.9% non-MTC gait cycles and Older 18.7%. In constrained walking conditions both groups increased non-MTC gait cycles and some older adults revealed over 90%, confirming non-MTC gait cycles as an ageing-related phenomenon in lower limb trajectory control. For all participants median indicative toe-height on non-MTC gait cycles was greater than median MTC height . This result suggests that eliminating the biomechanically hazardous MTC event by adopting more of the higher-clearance non-MTC gait cycles, is adaptive in reducing the likelihood of toe-ground contact. Copyright © 2017 Elsevier B.V. All rights reserved.

[Therapy of the peromelic form of symbrachydactyly by double second-toe transplantation].

PubMed

Hülsemann, W; Preisser, P; Habenicht, R; Partecke, B-D

2002-09-01

From 1989 to 2001 eleven children with the peromelic type of symbrachydactyly underwent a staged double second toes transplantation for restoration of two finger rays. The second toe of the feet were transplanted first to the small finger position and in the second step to the thumb position. One failure occurred in the first toe transplantation and another developed a venous thrombosis with partial necrosis and eventually a useless ray. Eight children were reviewed retrospectively in a mean follow-up of 5.3 years. The ability to pinch was restored in four children. In all patients without complications the function of the hand improved and the sensitivity was good.

Plantar-plate disruptions: "the severe turf-toe injury." three cases in contact athletes.

PubMed

Drakos, Mark C; Fiore, Russell; Murphy, Conor; DiGiovanni, Christopher W

2015-05-01

To present 3 cases of plantar-plate rupture and turf-toe injury in contact athletes at 1 university and to discuss appropriate diagnosis and treatment algorithms for each case. Turf toe is a common injury in athletes participating in outdoor cutting sports. However, it has been used as an umbrella term to describe many different injuries of the great toe. In some cases, the injury can be so severe that the plantar plate and sesamoid apparatus may be ruptured. These patients may be better managed with surgery than with traditional nonoperative interventions. Turf toe, plantar-plate disruption, sesamoid fracture. For stable injuries in which the plantar plate is not completely disrupted, nonoperative treatment with casting or a stiff-soled shoe, gradual weight bearing, and rehabilitation is the best practice. Unstable injuries require surgical intervention and plantar-plate repair. Turf toe and injury to the first metatarsophalangeal joint are relatively common injuries in athletes, but few researchers have detailed the operative and nonoperative treatments of plantar-plate disruption in these patients. We examine 3 cases that occurred over 4 seasons on a collegiate football team. Turf toe represents a wide array of pathologic conditions involving the first metatarsophalangeal joint. Stress and instability testing are key components to assess in determining whether surgical intervention is warranted to restore optimal function. Stiffer-soled shoes or shoes with steel-plate insertions may help to prevent these injuries and are useful tools for protection during the rehabilitation period.

Expression of Tac antigen component of bovine interleukin-2 receptor in different leukocyte populations infected with Theileria parva or Theileria annulata.

PubMed Central

Dobbelaere, D A; Prospero, T D; Roditi, I J; Kelke, C; Baumann, I; Eichhorn, M; Williams, R O; Ahmed, J S; Baldwin, C L; Clevers, H

1990-01-01

The Tac antigen component of the bovine interleukin-2 receptor was expressed as a Cro-beta-galactosidase fusion protein in Escherichia coli and used to raise antibodies in rabbits. These antibodies were used for flow cytofluorimetric analysis to investigate the expression of Tac antigen in a variety of Theileria parva-infected cell lines and also in three Theileria annulata-infected cell lines. Cells expressing Tac antigen on their surface were found in all T. parva-infected cell lines tested whether these were of T- or B-cell origin. T cells expressing Tac antigen could be CD4- CD8-, CD4+ CD8-, CD4- CD8+, or CD4+ CD8+. Tac antigen expression was observed both in cultures which had been maintained in the laboratory for several years and in transformed cell lines which had recently been established by infection of lymphocytes in vitro with T. parva. Northern (RNA) blot analysis demonstrated Tac antigen transcripts in RNA isolated from all T. parva-infected cell lines. Three T. annulata-infected cell lines which were not of T-cell origin were also tested. Two of them expressed Tac antigen on their surface. Abundant Tac antigen mRNA was detected in these T. annulata-infected cell lines, but only trace amounts were demonstrated in the third cell line, which contained very few Tac antigen-expressing cells. In all cell lines tested, whether cloned or uncloned, a proportion of the cells did not express detectable levels of Tac antigen on their surface. This was also the case for a number of other leukocyte surface markers. In addition, we showed that the interleukin-2 receptors were biologically functional, because addition of recombinant interleukin-2 to cultures stimulated cell proliferation. Recombinant interleukin-2 treatment also resulted in increased amounts of steady-state Tac antigen mRNA. The relevance of interleukin-2 receptor expression on Theileria-infected cells is discussed. Images PMID:1979317

Tachykinin 1 (TAC1) gene SNPs and haplotypes with autism: a case-control study.

PubMed

Marui, Tetsuya; Funatogawa, Ikuko; Koishi, Shinko; Yamamoto, Kenji; Matsumoto, Hideo; Hashimoto, Ohiko; Nanba, Eiji; Nishida, Hisami; Sugiyama, Toshiro; Kasai, Kiyoto; Watanabe, Keiichiro; Kano, Yukiko; Kato, Nobumasa; Sasaki, Tsukasa

2007-09-01

Autism (MIM 209850) is a severe neurodevelopmental disorder characterized by disturbances in social interaction and communication, by repetitive body movements and restricted interests, and by atypical language development. Several twin and family studies have shown strong evidence for genetic factors in the etiology of autism. Glutamate is a major excitatory neurotransmitter in the human brain. Glutamate systems are involved in the pathophysiology of autism. There are many similarities between the symptoms evoked by glutamate antagonist treatment and symptoms of autism found in several human and animal studies. To elucidate the genetic background of autism, we analyzed the relationship between three single nucleotide polymorphisms (SNPs) of the Tachykinin 1 gene (TAC1) and autism, because TAC1 is located in the candidate region for autism and produces substance P and neurokinins. These products modulate glutamatergic excitatory synaptic transmission and are also involved in inflammation. Many different inflammation-related mechanisms could be involved in the autistic brain. Therefore, TAC1 may have some functions associated with the presumable pathophysiology of autism. We compared the allele and haplotype frequencies between autistic patients (n=170) and normal controls (n=214) in the Japanese population, but no significant difference was observed. Thus, the TAC1 locus is not likely to play a major role in the development of autism.

Changes in toe clearance during treadmill walking after long-duration spaceflight.

PubMed

Miller, Christopher A; Peters, Brian T; Brady, Rachel R; Richards, Jason R; Ploutz-Snyder, Robert J; Mulavara, Ajitkumar P; Bloomberg, Jacob J

2010-10-01

Astronauts exhibit sensorimotor changes upon return from long-duration spaceflight that can result in altered gait kinematics and possibly an increased risk of tripping. Toe trajectory during locomotion is a precise motor control task involving both legs, thus providing a composite metric of locomotor control. The purpose of this study was to determine whether astronauts are at an increased risk of tripping after their return from long-duration spaceflight. This was accomplished by assessing the pre- to postflight changes in toe clearance during treadmill walking. Ten crewmembers walked on a treadmill while performing a visual-acuity task pre- and postflight. In the three subjects on whom landing day data were available, each exhibited a characteristic of increased tripping risk on landing day: either a decreased median toe clearance or an increased interquartile range (a measure of variance). For all crewmembers, toe clearance median and interquartile range were not significantly different from preflight for the other postflight sessions (the earliest being 1 d after landing). A follow-up analysis showed that changes in foot pitch, ankle dorsiflexion, and pelvis roll angles were significant predictors of changes in toe clearance. The landing-day observations indicated an increased risk of tripping, which may pose a hazard during locomotion immediately upon return to Earth, especially in an emergency scenario. However, tripping risk on subsequent days was not different than preflight. The joint angle analysis suggested that the crewmembers tried to reestablish their normal walking pattern postflight, instead of developing a new motor control strategy.

The Influence of Environmental Consequences and Internalizing Symptoms on Children's Tic Severity.

PubMed

Eaton, Cyd K; Jones, Anna M; Gutierrez-Colina, Ana M; Ivey, Emily K; Carlson, Olivia; Melville, Lauren; Kardon, Patricia; Blount, Ronald L

2017-04-01

Although there is evidence that environmental consequences for displaying tics and internalizing symptoms are related to tic severity in children with TS, less is known about the inter-relationships of these variables or how these factors jointly contribute to tic severity. This study included 45 children with Tourette syndrome. Caregivers reported on children's environmental consequences for displaying tics, internalizing symptoms, and tic severity. Results indicated that children with higher levels of internalizing symptoms experienced significantly more environmental consequences for displaying tics. Children with higher levels of separation anxiety symptoms demonstrated significantly greater tic severity. Environmental consequences for displaying tics accounted for significantly more variance in predicting tic severity than anxiety symptoms. This preliminary evidence suggests that environmental consequences for displaying tics, such as receiving accommodations or attention from others, have a greater influence on children's tic severity than emotional factors.

Self-initiated coping with Tourette's syndrome: Effect of tic suppression on QOL.

PubMed

Matsuda, Natsumi; Kono, Toshiaki; Nonaka, Maiko; Fujio, Miyuki; Kano, Yukiko

2016-02-01

Because of the semi-voluntary nature of tics, patients with Tourette' syndrome (TS) often report self-initiated coping with tics. Our goals were to understand the experiences of self-initiated coping with tics by individuals with TS (e.g., suppression frequency, suppression ability, and side effects of tic suppression), and investigate the effects of tic control on quality of life (QOL). One hundred participants with TS (38 children and 62 adults) answered a questionnaire concerning tic control, QOL, and other clinical characteristics. Fifty-eight percent of the participants always or frequently tried to suppress tics daily. In contrast, over 90% felt uncomfortable or incomplete when they suppressed tics and needed concentration or extra effort to suppress them. Thirty-four percent could suppress tics for less than one minute and 65% could suppress tics for less than 10min. Higher subjective satisfaction with tic control was positively correlated with life satisfaction and QOL. Individuals with TS often attempt self-initiated coping in their daily lives, especially through tic suppression, despite experiencing subjective discomfort and being aware that the duration of tic suppression is often limited. Moreover, it was found that their subjective satisfaction with tic control and effective tic suppression might have a positive influence on their life satisfaction and QOL. Thus, self-initiated coping with tics is vital for improving the QOL of individuals with TS and intervention aimed at enhancing subjective satisfaction with tic control could help manage TS. Copyright © 2015 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

Novel Psychological Formulation and Treatment of "Tic Attacks" in Tourette Syndrome.

PubMed

Robinson, Sally; Hedderly, Tammy

2016-01-01

One important, but underreported, phenomenon in Tourette syndrome (TS) is the occurrence of "tic attacks." These episodes have been described at conferences as sudden bouts of tics and/or functional tic-like movements, lasting from 15 min to several hours. They have also been described by patients in online TS communities. To date, there are no reports of tic attacks in the literature. The aim of this article is to stimulate discussion and inform clinical practices by describing the clinical presentation of 12 children (mean age 11 years and 3 months; SD = 2 years and 4 months) with TS and tic attacks, with a detailed case report for one case (13-year-old male). These children commonly present acutely to casualty departments and undergo unnecessary medical investigations. Interestingly, all children reported comorbid anxiety, with worries about the tics themselves and an increased internal focus of attention on tics once the attacks had started. In keeping with other children, the index case reported a strong internal focus of attention, with a relationship between physiological sensations/tic urges, worries about having tic attacks, and behavioral responses (e.g., body scanning, situational avoidance, and other responses). In our experience, the attacks reduce with psychological therapy, for example, the index case attended 13 sessions of therapy that included metacognitive and attention training techniques, as well as cognitive-behavioral strategies. Following treatment, an improvement was seen across a range of measures assessing tics, mood, anxiety, and quality of life. Thus, psychological techniques used to treat anxiety disorders are effective at supporting a reduction in tic attacks through modifying attention, worry processes, and negative beliefs. It is hypothesized that an attentional style of threat monitoring, difficulties tolerating internal sensory urges, cognitive misattributions, and maladaptive coping strategies contribute to the

Molded foot orthosis after great toe or medial ray amputations in diabetic feet.

PubMed

Due, T M; Jacobs, R L

1985-12-01

Necrosis of the tip of the next lateral remaining toe has been found to be a late complication of great toe and medial ray amputations in diabetic feet. The use of custom-molded insert foot orthoses helps avoid this complication.

[Motor disorders in neurodevelopmental disorders. Tics and stereotypies].

PubMed

Eirís-Puñal, Jesús

2014-02-24

Tics are repetitive, sharp, rapid, non-rhythmic movements or utterances that are the result of sudden, abrupt and involuntary muscular contractions. Stereotypies are repetitive, apparently impulsive, rhythmic, purposeless movements that follow an individual repertoire that is specific to each individual and that occur under a variable time pattern, which may be either transient or persistent. Both are included in the Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5), among the neurodevelopmental disorders, and together with coordination development disorder go to make up the group of motor disorders. For tics, the categories of 'Tourette's disorder', 'chronic motor or vocal tic disorder' and 'unspecified tic disorder' have been maintained, whereas the category 'transient tics' has disappeared and 'provisional tic disorder' and 'other specified tic disorders' have been incorporated. Within stereotypic movement disorder, the DSM-5 replaces 'non-functional' by 'apparently purposeless'; the thresholds of the need for medical care are withdrawn and replaced with the manual's standard involvement criterion; mental retardation is no longer mentioned and emphasis is placed on the severity of the stereotypic movement; and a criterion concerning the onset of symptoms and specifiers of the existence or not of self-injurious behaviours have been added, together with the association with genetic or general medical diseases or extrinsic factors. Moreover, a categorisation depending on severity has also been included.

Prevalence and phenomenology of eye tics in Gilles de la Tourette syndrome.

PubMed

Martino, Davide; Cavanna, Andrea E; Robertson, Mary M; Orth, Michael

2012-10-01

Eye tics seem to be common in Gilles de la Tourette syndrome (GTS). We analyzed the frequency and clinical characteristics of eye tics in 212 GTS patients. Of the 212 patients, 201 (94.8 %) reported eye tics in their life-time; 166 (78.3 %) reported eye movement tics (rolling eyes up/down, eyes looking sideways, staring), and 194 (91.5 %) eyelid/eyebrow movement tics (frowning, raising eyebrows, blinking or winking). Patients with eye movement tics were younger at age of GTS onset (7.1 ± 4 years) than those without (8.9 ± 6.8; p = 0.024). Tic severity positively correlated to lifetime history of eye and/or eyelid/eyebrow movement tics. Our data confirm that eye and eyelid/eyebrow movement tics are very common in GTS, and most patients have several types of eye tics over time. Eye tic phenomenology was similar in patients with or without co-morbidity. Eye tics are therefore likely to be a core feature of GTS and should be routinely evaluated in order to strengthen the clinician's confidence in diagnosing GTS.

Evaluating the Role of Contingency in Differentially Reinforced Tic Suppression

ERIC Educational Resources Information Center

Himle, Michael B.; Woods, Douglas W.; Bunaciu, Liviu

2008-01-01

The current study evaluated the effects of tokens delivered on differential reinforcement of zero-rate behavior (DRO) schedules or noncontingently on tic suppression in 4 children with tics. Tic frequency was lower in 3 of 4 children when tokens were delivered contingent on the absence of tics than when tokens were delivered noncontingently.…

Heel and toe driving on fuel cell vehicle

DOEpatents

Choi, Tayoung; Chen, Dongmei

2012-12-11

A system and method for providing nearly instantaneous power in a fuel cell vehicle. The method includes monitoring the brake pedal angle and the accelerator pedal angle of the vehicle, and if the vehicle driver is pressing both the brake pedal and the accelerator pedal at the same time and the vehicle is in a drive gear, activating a heel and toe mode. When the heel and toe mode is activated, the speed of a cathode compressor is increased to a predetermined speed set-point, which is higher than the normal compressor speed for the pedal position. Thus, when the vehicle brake is removed, the compressor speed is high enough to provide enough air to the cathode, so that the stack can generate nearly immediate power.

AN/TAC-1 demultiplexer circuit card assembly

NASA Astrophysics Data System (ADS)

Krueger, Paul J.

1989-01-01

This report describes the design, operation, and testing of the AN/TAC-1 demultiplexer subassembly. It demultiplexes the 6144 kb/s digital data stream received over fiber optic cable or tropo satellite support radio, and converts it into 2 digital groups and 16 digital channels. Timing recovery is accomplished by generating a 18432 kHz master clock synchronized to the incoming data. This master clock is divided modulo two to generate the proper group and loop timing.

Establishing the feasibility of direct observation in the assessment of tics in children with chronic tic disorders.

PubMed

Himle, Michael B; Chang, Susanna; Woods, Douglas W; Pearlman, Amanda; Buzzella, Brian; Bunaciu, Liviu; Piacentini, John C

2006-01-01

Behavior analysis has been at the forefront in establishing effective treatments for children and adults with chronic tic disorders. As is customary in behavior analysis, the efficacy of these treatments has been established using direct-observation assessment methods. Although behavior-analytic treatments have enjoyed acceptance and integration into mainstream health care practices for tic disorders (e.g., psychiatry and neurology), the use of direct observation as a primary assessment tool has been neglected in favor of less objective methods. Hesitation to use direct observation appears to stem largely from concerns about the generalizability of clinic observations to other settings (e.g., home) and a lack of consensus regarding the most appropriate and feasible techniques for conducting and scoring direct observation. The purpose of the current study was to evaluate and establish a reliable, valid, and feasible direct-observation protocol capable of being transported to research and clinical settings. A total of 43 children with tic disorders, collected from two outpatient specialty clinics, were assessed using direct (videotape samples) and indirect (Yale Global Tic Severity Scale; YGTSS) methods. Videotaped observation samples were collected across 3 consecutive weeks and two different settings (clinic and home), were scored using both exact frequency counts and partial-interval coding, and were compared to data from a common indirect measure of tic severity (the YGTSS). In addition, various lengths of videotaped segments were scored to determine the optimal observation length. Results show that (a) clinic-based observations correspond well to home-based observations, (b) brief direct-observation segments scored with time-sampling methods reliably quantified tics, and (c) indirect methods did not consistently correspond with the direct methods.

Animal models of tic disorders: a translational perspective.

PubMed

Godar, Sean C; Mosher, Laura J; Di Giovanni, Giuseppe; Bortolato, Marco

2014-12-30

Tics are repetitive, sudden movements and/or vocalizations, typically enacted as maladaptive responses to intrusive premonitory urges. The most severe tic disorder, Tourette syndrome (TS), is a childhood-onset condition featuring multiple motor and at least one phonic tic for a duration longer than 1 year. The pharmacological treatment of TS is mainly based on antipsychotic agents; while these drugs are often effective in reducing tic severity and frequency, their therapeutic compliance is limited by serious motor and cognitive side effects. The identification of novel therapeutic targets and development of better treatments for tic disorders is conditional on the development of animal models with high translational validity. In addition, these experimental tools can prove extremely useful to test hypotheses on the etiology and neurobiological bases of TS and related conditions. In recent years, the translational value of these animal models has been enhanced, thanks to a significant re-organization of our conceptual framework of neuropsychiatric disorders, with a greater focus on endophenotypes and quantitative indices, rather than qualitative descriptors. Given the complex and multifactorial nature of TS and other tic disorders, the selection of animal models that can appropriately capture specific symptomatic aspects of these conditions can pose significant theoretical and methodological challenges. In this article, we will review the state of the art on the available animal models of tic disorders, based on genetic mutations, environmental interventions as well as pharmacological manipulations. Furthermore, we will outline emerging lines of translational research showing how some of these experimental preparations have led to significant progress in the identification of novel therapeutic targets for tic disorders. Copyright © 2014 Elsevier B.V. All rights reserved.

Animal models of tic disorders: A translational perspective

PubMed Central

Godar, Sean C.; Mosher, Laura J.; Di Giovanni, Giuseppe; Bortolato, Marco

2014-01-01

Tics are repetitive, sudden movements and/or vocalizations, typically enacted as maladaptive responses to intrusive premonitory urges. The most severe tic disorder, Tourette syndrome (TS), is a childhood-onset condition featuring multiple motor and at least one phonic tic for a duration longer than 1 year. The pharmacological treatment of TS is mainly based on antipsychotic agents; while these drugs are often effective in reducing tic severity and frequency, their therapeutic compliance is limited by serious motor and cognitive side effects. The identification of novel therapeutic targets and development of better treatments for tic disorders is conditional on the development of animal models with high translational validity. In addition, these experimental tools can prove extremely useful to test hypotheses on the etiology and neurobiological bases of TS and related conditions. In recent years, the translational value of these animal models has been enhanced, thanks to a significant re-organization of our conceptual framework of neuropsychiatric disorders, with a greater focus on endophenotypes and quantitative indices, rather than qualitative descriptors. Given the complex and multifactorial nature of TS and other tic disorders, the selection of animal models that can appropriately capture specific symptomatic aspects of these conditions can pose significant theoretical and methodological challenges. In this article, we will review the state of the art on the available animal models of tic disorders, based on genetic mutations, environmental interventions as well as pharmacological manipulations. Furthermore, we will outline emerging lines of translational research showing how some of these experimental preparations have led to significant progress in the identification of novel therapeutic targets for tic disorders. PMID:25244952

EXPOSURE ASSESSMENT FINDINGS FROM THE TAMPA ASTHMATIC CHILDREN'S STUDY (TACS)

EPA Science Inventory

The Tampa Asthmatic Children's Study (TACS) was a pilot study that focused on developing and evaluating air pollution exposure assessment methods and participant recruiting tools. The four-week study was performed in October and November, 2003. The study involved repeated daily...

Material and biofilm load of K wires in toe surgery: titanium versus stainless steel.

PubMed

Clauss, Martin; Graf, Susanne; Gersbach, Silke; Hintermann, Beat; Ilchmann, Thomas; Knupp, Markus

2013-07-01

Recurrence rates for toe deformity correction are high and primarily are attributable to scar contractures. These contractures may result from subclinical infection. We hypothesized that (1) recurrence of toe deformities and residual pain are related to low-grade infections from biofilm formation on percutaneous K wires, (2) biofilm formation is lower on titanium (Ti) K wires compared with stainless steel (SS) K wires, and (3) clinical outcome is superior with the use of Ti K wires compared with SS K wires. In this prospective nonrandomized, comparative study, we investigated 135 lesser toe deformities (61 patients; 49 women; mean ± SD age, 60 ± 15 years) temporarily fixed with K wires between August 2010 and March 2011 (81 SS, 54 Ti). K wires were removed after 6 weeks. The presence of biofilm-related infections was analyzed by sonication. High bacterial loads (> 500 colony-forming units [CFU]/mL) were detected on all six toes requiring revision before 6 months. Increased bacterial load was associated with pain and swelling but not recurrence of the deformity. More SS K wires had greater than 100 CFU/mL bacteria than Ti K wires. For K wires with a bacterial count greater than 100 CFU/mL, toes with Ti K wires had a lower recurrence rate, less pain, and less swelling than toes with SS K wires. Ti K wires showed superior clinical outcomes to SS K wires. This appears to be attributable to reduced infection rates. Although additional study is needed, we currently recommend the use of Ti K wires for the transfixation of toe deformities. Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Repair, Evaluation, Maintenance, and Rehabilitation Research Program. Stability of Toe Berm Armor Stone and Toe Buttressing Stone on Rubble-Mound Breakwaters and Jetties. Physical Model Investigation

DTIC Science & Technology

1989-09-01

Rehabilitation of Rubble-Mound Structure Toes. The first objective of this work unit was to gain an iinderstanding of the toe stability problems experi- enced ...6.75-FT WAVE FLUMES 12.0- 11.0 - Be10.0- z 0 8.0 0 n- 7.0- _U Z 0 0 6.0 --- (0cc 5.0- h 0 0 LADo cc 4.0 0 . 0 -3 -P - -2 - - 01.0-0.0- - 0_0 co 2.0

Functional neuroanatomy of tics.

PubMed

Neuner, Irene; Schneider, Frank; Shah, N Jon

2013-01-01

The therapeutic success of haloperidol in the treatment of Tourette syndrome (TS) put an end to the discussion about a "hysteric" or "neurotic" origin of TS. The cortico-striato-thalamo-cortical circuit has been identified as an underlying neurobiological correlate of TS. In this review we explore the main findings of structural alterations in TS including cortical areas, basal ganglia, hippocampus, amygdala, midbrain, and cerebellum. Based on the structural changes we examine the functional pattern described by the findings of fMRI and (15)O-PET/(18)FDG PET investigations. From the neuroimaging findings a cortical origin of the generation of tics is indicated. Future research on the neuronal footprint of TS should be directed towards addressing the question of which patterns of connectivity distinguish individuals in whom tics disappear during early adulthood from those in whom the tics persist. The understanding of this pathomechanism could provide a key on how to influence dysconnectivity in TS, for example, by more specific pharmaceutical intervention or by individually adopted EEG and/or fMRI neurofeedback. © 2013 Elsevier Inc. All rights reserved.

3D Printing Technology in Planning Thumb Reconstructions with Second Toe Transplant.

PubMed

Zang, Cheng-Wu; Zhang, Jian-Lei; Meng, Ze-Zu; Liu, Lin-Feng; Zhang, Wen-Zhi; Chen, Yong-Xiang; Cong, Rui

2017-05-01

To report preoperative planning using 3D printing to plan thumb reconstructions with second toe transplant. Between December 2013 and October 2015, the thumbs of five patients with grade 3 thumb defects were reconstructed using a wrap-around flap and second toe transplant aided by 3D printing technology. CT scans of hands and feet were analyzed using Boholo surgical simulator software (www.boholo.com). This allowed for the creation of a mirror image of the healthy thumb using the uninjured thumb. Using 3D images of the reconstructed thumb, a model of the big toe and the second toe was created to understand the dimensions of the donor site. This model was also used to repair the donor site defect by designing appropriate iliac bone and superficial circumflex iliac artery flaps. The polylactic acid model of the donor toes and reconstructed thumb was produced using 3D printing. Surgically, the wrap-around flap of the first dorsal metatarsal artery and vein combined with the joint and bone of the second toe was based upon the model donor site. Sensation was reconstructed by anastomosing the dorsal nerve of the foot and the plantar digital nerve of the great toe. Patients commenced exercises 2 weeks after surgery. All reconstructed thumbs survived, although partial flap necrosis occurred in one case. This was managed with regular dressing changes. Patients were followed up for 3-15 months. The lengths of the reconstructed thumbs are 34-49 mm. The widths of the thumb nail beds are 16-19 mm, and the thickness of the digital pulp is 16-20 mm. The thumb opposition function was 0-1.5 cm; the extension angle was 5°-20° (mean, 16°), and the angle of flexion was 38°-55° (mean, 47°). Two-point discrimination was 9-11 mm (mean, 9.6 mm). The reconstructed thumbs had good appearance, function and sensation. Based on the criteria set forth by the Standard on Approval of Reconstructed Thumb and Finger Functional Assessment of the Chinese Medical Association, the results were

Epigenome-Wide Association Study of Tic Disorders.

PubMed

Zilhão, Nuno R; Padmanabhuni, Shanmukha S; Pagliaroli, Luca; Barta, Csaba; Smit, Dirk J A; Cath, Danielle; Nivard, Michel G; Baselmans, Bart M L; van Dongen, Jenny; Paschou, Peristera; Boomsma, Dorret I

2015-12-01

Tic disorders are moderately heritable common psychiatric disorders that can be highly troubling, both in childhood and in adulthood. In this study, we report results obtained in the first epigenome-wide association study (EWAS) of tic disorders. The subjects are participants in surveys at the Netherlands Twin Register (NTR) and the NTR biobank project. Tic disorders were measured with a self-report version of the Yale Global Tic Severity Scale Abbreviated version (YGTSS-ABBR), included in the 8th wave NTR data collection (2008). DNA methylation data consisted of 411,169 autosomal methylation sites assessed by the Illumina Infinium HumanMethylation450 BeadChip Kit (HM450k array). Phenotype and DNA methylation data were available in 1,678 subjects (mean age = 41.5). No probes reached genome-wide significance (p < 1.2 × 10(-7)). The strongest associated probe was cg15583738, located in an intergenic region on chromosome 8 (p = 1.98 × 10(-6)). Several of the top ranking probes (p < 1 × 10(-4)) were in or nearby genes previously associated with neurological disorders (e.g., GABBRI, BLM, and ADAM10), warranting their further investigation in relation to tic disorders. The top significantly enriched gene ontology (GO) terms among higher ranking methylation sites included anatomical structure morphogenesis (GO:0009653, p = 4.6 × 10-(15)) developmental process (GO:0032502, p = 2.96 × 10(-12)), and cellular developmental process (GO:0048869, p = 1.96 × 10(-12)). Overall, these results provide a first insight into the epigenetic mechanisms of tic disorders. This first study assesses the role of DNA methylation in tic disorders, and it lays the foundations for future work aiming to unravel the biological mechanisms underlying the architecture of this disorder.

Emotional development in children with tics: a longitudinal population-based study.

PubMed

Hoekstra, P J; Lundervold, A J; Lie, S A; Gillberg, C; Plessen, Kerstin J

2013-03-01

Children with tics often experience accompanying problems that may have more impact on their well being and quality of life than the tics themselves. The present study investigates characteristics and the course of associated problems. In a population-based follow-up study, we investigated the developmental trajectory of children with and without tics when they were 7-9 years old. Parents and teachers completed the strengths and difficulties questionnaire (SDQ) when the children were 7-9 years (wave 1) and 4 years later (wave 2). Using strict criteria, we identified 38 children with tics in the cohort of 4,025 children (0.94% of the total cohort) with a preponderance of boys (78.9%). 22 children (57.9%) in the group with tics had only motor tics, and 16 (42.1%) had both motor and vocal tics. Children with tics had significantly higher parent- and teacher-rated SDQ total difficulty scores and subscale scores in both waves. Children with tics experienced an increase in emotional problems and in peer problems between the first and the second wave. This study in a general population indicates that the presence of tics is associated with a range of internalizing and externalizing difficulties, as well as problems in peer relationships. Moreover, our study indicates that emotional and peer problems tend to increase over time in the group of children with tics.

[Tics and Gilles de la Tourette syndrome].

PubMed

Tijero-Merino, B; Gómez-Esteban, J C; Zarranz, J J

2009-01-23

Tourette syndrome is a neurologic disorder characterized by involuntary vocal and motor tics. It affects around 1 to 2% of school-age children and is the most common movement disorder in paediatric age. Tics are involuntary or semivoluntary, sudden, brief, intermittent, repetitive movements (motor tics) or sounds (phonic tics). It is often associated with psychiatric comorbidities, mainly attention-deficit/hyperactivity disorder and obsessive-compulsive disorder. Given its diverse presentation, Tourette's syndrome can almost mimic many hyperkinetic disorders, making the diagnosis challenging at times. The etiology of this syndrome is thought to be related to basal ganglia dysfunction and many clues have been pursued, both genetic and environmental factors, but no compelling major contribution to the pathogenesis of the disease has yet emerged. Treatment can be behavioural, pharmacologic, or surgical, and is dictated by the most incapacitating symptoms. Alpha-2-adrenergic agonists are the first line of pharmacologic therapy, but dopamine-receptor-blocking drugs are required for multiple, complex tics. Dopamine-receptor-blocking drugs are associated with potential side effects. Appropriate diagnosis and treatment can substantially improve quality of life and psychosocial functioning in affected patients.

[Therapeutic management of tics in Tourette's syndrome].

PubMed

Diallo, R; Welter, M L; Mallet, L

2007-03-01

Tourette's syndrome is a neuropsychiatric disorder characterised by both involuntary movements, tics, and psychiatric symptoms, attentional deficit disorder, hyperactivity, obsessive compulsive symptoms..., and can be the cause of major disability. Over the past 30 years, several types of treatment have been proposed for the treatment of tics in Tourette's Syndrome, ranging from psychotherapeutic approaches to neurosurgery. The education of the patient and his entourage is fundamental and must be offered to all patients. Psychotherapy does not directly improve the tics but contributes to a better adjustment of both patient and carers to his disability. The decision to start a course of drug therapy depends largely on the impact of the patient's tics on his personal life. Drug treatment relies on neuromodulators acting on a variety of neural systems and whose efficacy has been rarely demonstrated. The literature shows that the latest generation of dopaminergic antagonists have the highest benefit/risk ratio. Recently, deep brain stimulation, by modulating neuronal activity in structures involved in the pathophysiology of the disease, has become a promising therapeutical approach, producing a marked decrease in the severity of tics over that obtained with other treatments.

SPECT (HMPAO) support for activation of the medial prefrontal cortices during toe graphaesthesia.

PubMed

Persinger, M A; Webster, D; Tiller, S G

1998-08-01

This experiment was designed to test the construct validity of psychometric analyses that suggested a strong functional association between the accuracy for toe graphaesthesia and selective activation of neurons within the medial prefrontal regions. Single Photon Emission Computerized Tomography (SPECT) profiles were obtained for three volunteers (2 men, 1 woman) after they had been exposed to a toe graphaesthesia task or had been exposed to the control setting. The two measurements for each participant were separated by at least one week. Qualitative evaluation, using criteria employed for clinical diagnoses, of serial coronal, sagittal, and horizontal sections clearly indicated a specific increase in uptake of tracer within the rostral one-third to one-half of the medial prefrontal cortices of all three subjects during the toe graphaesthesia task compared to that during baseline conditions. The results are consistent with our neuropsychological research which indicates that toe graphaesthesia may be an accurate and useful indicator of the functional integrity of the medial surfaces of the anterior cerebral hemispheres.

Mathematics Learning Assisted Geogebra using Technologically Aligned Classroom (TAC) to Improve Communication Skills of Vocasional High School Student

NASA Astrophysics Data System (ADS)

Yuliardi, R.; Nurjanah

2017-09-01

The purpose of this study to analyze mathematical communication skill’s student to resolve geometry transformation problems through computer Assisted Geogebra using Technologically Aligned Classroom (TAC). The population in this study were students from one of Vocasional High School Student in West Java. Selection of sample by purposed random sampling, the experimental class is taught Technologically Aligned Classroom (TAC) with GeoGebra, while the control class is taught by conventional learning. This study was quasi-experimental with pretest and posttest control group design. Based on the results; (1) The enhancement of student mathematical communication skills through TAC was higher than the conventional learning; (2) based on gender, there were no differences of mathematical communication skilss student who exposed with TAC and conventional learning; (3) based on KAM test, there was significant enhancement of students’ communication skills among ability of high, middle, and low KAM. The differences occur between high KAM and middle KAM, and also between high KAM and low KAM. Based on this result, mathematics learning Assisted Geogebra using Technologically Aligned Classroom (TAC) can be applied in the process of Mathematics Learning in Vocasional High School.

[Lesser toe deformities. Definition, pathogenesis, and options for surgical correction].

PubMed

Arnold, H

2005-08-01

Whereas in the past resection arthroplasty was - in analogy to hallux valgus surgery - the preferred therapy to correct lesser toe deformities, the point of view has undergone a change. Much interest is directed toward functional aspects that require reconstructive management. Whenever possible the integrity of joint play should be saved. Above all the metatarsophalangeal joint of the lesser toes is worth being preserved to prevent a severe disturbance of the biomechanics of the foot. Tendon transfers and subtle corrective osteotomies such as the Weil procedure allow restricting resection procedures to contraction deformities.

A new treatment for parrot beak deformity of the toe.

PubMed

Kurokawa, M; Isshiki, N; Inoue, K

1994-03-01

Two cases of congenital parrot beak deformity of the toe were treated by pushing back the nail plate, nailbed, matrix, and proximal skin fold in one piece as a flap. The proximal skin portion of this flap was deepithelialized to facilitate this shift, and thus no dog-ear deformity was produced. The distal skin defect of the pulp was covered by a palmar advancement flap. This method does not require augmentation of the fingertip or toetip and is very useful for correcting parrot beak deformities of the toes.

Corticostriatal Divergent Function in Determining the Temporal and Spatial Properties of Motor Tics

PubMed Central

Israelashvili, Michal

2015-01-01

Striatal disinhibition leads to the formation of motor tics resembling those expressed during Tourette syndrome and other tic disorders. The spatial properties of these tics are dependent on the location of the focal disinhibition within the striatum; however, the factors affecting the temporal properties of tic expression are still unknown. Here, we used microstimulation within the motor cortex of freely behaving rats before and after striatal disinhibition to explore the factors underlying the timing of individual tics. Cortical activation determined the timing of individual tics via an accumulation process of inputs that was dependent on the frequency and amplitude of the inputs. The resulting tics and their neuronal representation within the striatum were highly stereotypic and independent of the cortical activity properties. The generation of tics was limited by absolute and relative tic refractory periods that were derived from an internal striatal state. Thus, the precise time of the tic expression depends on the interaction between the summation of incoming excitatory inputs to the striatum and the timing of the previous tic. A data-driven computational model of corticostriatal function closely replicated the temporal properties of tic generation and enabled the prediction of tic timing based on incoming cortical activity and tic history. These converging experimental and computational findings suggest a clear functional dichotomy within the corticostriatal network, pointing to disparate temporal (cortical) versus spatial (striatal) encoding. Thus, the abnormal striatal inhibition typical of Tourette syndrome and other tic disorders results in tics due to cortical activation of the abnormal striatal network. SIGNIFICANCE STATEMENT The factors underlying the temporal properties of tics expressed in Tourette syndrome and other tic disorders have eluded clinicians and scientists for decades. In this study, we highlight the key role of corticostriatal activity

The effect of pretest rest time on automated measures of toe systolic blood pressure and the toe brachial index.

PubMed

Sadler, Sean G; Hawke, Fiona E; Chuter, Vivienne H

2015-10-01

Evaluation of peripheral blood supply is fundamental to risk categorization and subsequent ongoing monitoring of patients with lower extremity peripheral arterial disease. Toe systolic blood pressure (TSBP) and the toe brachial index (TBI) are both valid and reliable vascular screening techniques that are commonly used in clinical practice. However, the effect of pretest rest duration on the magnitude of these measurements is unclear. Eighty individuals meeting current guidelines for lower extremity peripheral arterial disease screening volunteered to participate. The Systoe and MicroLife automated devices were used to measure toe and brachial systolic blood pressures, respectively, following 5, 10 and 15 min of rest in a horizontal supine position. A ratio of TSBP to brachial pressure was used to calculate the TBI and change in TBI at each time interval was investigated. A significant increase in TSBP [3.66 mmHg; 95% confidence interval (CI): 1.44-5.89; P≤0.001] and the TBI (0.03; 95% CI: 0.01-0.05; P≤0.001) occurred between 5 and 10 min. Between 10 and 15 min, there was a nonsignificant decrease in TSBP (-0.73 mmHg; 95% CI: -1.48 to 2.93; P=1.000) and the TBI (0.00; 95% CI: -0.02 to 0.02; P=1.000). Ten minutes of pretest rest is recommended for measurement of TSBP and for both pressure measurements used in the calculation of a TBI to ensure that stable pressures are measured.

Tics as signs of catatonia: electroconvulsive therapy response in 2 men.

PubMed

Dhossche, Dirk M; Reti, Irving M; Shettar, Shashidhar M; Wachtel, Lee E

2010-12-01

Tics have rarely been described in catatonia although tics are sudden and nonrhythmic variants of stereotypic or repetitive movement abnormalities that are considered cardinal symptoms of catatonia. We describe 2 men with tics and self-injurious behavior, who met criteria for catatonia. One patient met criteria for autism. We reported 2 new cases and performed a literature review using PubMed to identify other cases of tics that were treated with electroconvulsive therapy. Tics along with other catatonic symptoms and self-injurious behavior responded to electroconvulsive therapy in 2 men. Eight other patients with tics that were treated with electroconvulsive therapy were found in the literature. Catatonia was recognized in 4 of the 8 patients. Two patients met criteria for autism. Tics, with or without self-injurious behavior, may be signs of catatonia. Patients with tics or Tourette syndrome warrant assessment for catatonia. If catatonia is present, electroconvulsive therapy provides a safe but rarely used alternative to pharmacotherapy, psychosurgery, or invasive brain stimulation in the treatment of tics and Tourette syndrome. © 2010 Lippincott Williams & Wilkins, Inc.

Kinematic Gait Changes Following Serial Casting and Bracing to Treat Toe Walking in a Child With Autism.

PubMed

Barkocy, Marybeth; Dexter, James; Petranovich, Colleen

2017-07-01

To evaluate the effectiveness of serial casting in a child with autism spectrum disorder (ASD) exhibiting a toe-walking gait pattern with equinus contractures. Although many children with ASD toe walk, little research on physical therapy interventions exists for this population. Serial casting has been validated for use in idiopathic toe walking to increase passive dorsiflexion and improve gait, but not for toe walking in children with ASD. Serial casting followed by ankle-foot orthosis use was implemented to treat a child with ASD who had an obligatory equinus gait pattern. Gait analysis supported improvements in kinematic, spatial, and temporal parameters of gait, and the child maintained a consistent heel-toe gait at 2-year follow-up. STATEMENT OF CONCLUSION AND RECOMMENDATIONS FOR CLINICAL PRACTICE:: Serial casting followed by ankle-foot orthosis use is a viable treatment option for toe walking in children with ASD.

Immediate toe-to-hand transfer in acute hand injuries: overall results, compared with results for elective cases.

PubMed

Woo, Sang-Hyun; Kim, Joo-Sung; Seul, Jung-Hyun

2004-03-01

In the past 5 years, 25 mutilated digits were reconstructed with immediate toe-to-hand transfers after acute hand injuries, for 21 patients. The overall results of the immediate toe-to-hand transfers were evaluated and compared with the results of 65 elective procedures performed during the same period by the same surgeon. There were 15 cases of great toe-to-hand transfer for thumb reconstruction, two cases of second toe transfer for index finger reconstruction, and four cases of simultaneous two-toe transfer for reconstruction of multiple-digit amputations. Two cases (two of 25 cases, 8 percent) were successfully salvaged with emergency reexploration. The incidences of emergency reexploration and postoperative infection were not significantly different from those for elective toe-to-hand transfer cases. The duration of industrial insurance coverage was much shorter than for elective cases, averaging 225 days (p < 0.001). Approximately 44 percent of the patients maintained their original jobs after immediate toe-to-hand transfer. The subjective satisfaction self-assessment scores of aesthetic appearance and function for the newly reconstructed thumb averaged 80 and 88 (of a total score of 100), respectively. Although satisfaction was lower than for elective reconstruction (p < 0.001), it was higher than for reconstruction of other digits. The donor-site appearance after great toe harvesting was mostly unsatisfactory. Immediate toe-to-hand transfer provides many advantages over the elective procedure in acute hand injuries, including single-stage reconstruction, shortened convalescence, early return to work, and socioeconomic efficiency. Because there were no significant differences in the success rates, frequencies of complications, or ultimate functional results, immediate toe-to-hand transfer is a safe and reliable procedure that is indicated for specific cases of acute digital amputation.

The status and road map of Turkish Accelerator Center (TAC)

NASA Astrophysics Data System (ADS)

Yavaş, Ö.

2012-02-01

Turkish Accelerator Center (TAC) project is supported by the State Planning Organization (SPO) of Turkey and coordinated by Ankara University. After having completed the Feasibility Report (FR) in 2000 and the Conceptual Design Report (CDR) in 2005, third phase of the project started in 2006 as an inter-universities project including ten Turkish Universities with the support of SPO. Third phase of the project has two main scientific goals: to prepare the Technical Design Report (TDR) of TAC and to establish an Infrared Free Electron Laser (IR FEL) facility, named as Turkish Accelerator and Radiation Laboratory at Ankara (TARLA) as a first step. The facility is planned to be completed in 2015 and will be based on 15-40 MeV superconducting linac. In this paper, main aims, national and regional importance, main parts main parameters, status and road map of Turkish Accelerator Center will be presented.

[Care continuity for patients with tic disorders during transition from childhood to adulthood].

PubMed

Kano, Yukiko

2010-01-01

Chronic tic disorders including Tourette syndrome are defined as disorders with tics continuing for over a year. Although a substantial portion of patients with chronic tic disorders have improvement or remission of their tics until adulthood, some of them still have necessity to receive treatment for tic disorders in adulthood. Regardless of age and severity of tics, basic treatment for tic disorders consists of psycho-education and family guidance which encourage patients and people around them to understand, accept and cope with tics appropriately. In most of the adult cases with tic disorders who require aggressive treatment, tics and/or comorbidities including obsessive-compulsive symptoms are so severe that they usually have medication including antipsychotics.

Reactivity of Tic Observation Procedures to Situation and Setting

ERIC Educational Resources Information Center

Piacentini, John; Himle, Michael B.; Chang, Susanna; Baruch, David E.; Buzzella, Brian A.; Pearlman, Amanda; Woods, Douglas W.

2006-01-01

Tic frequency was assessed and compared across home and clinic as well as three experimentally-manipulated situations in order to assess the phenomenon of tic reactivity. Forty-three youngsters with chronic tic disorder recruited from two geographically-distinct sites were videotaped over three weekly laboratory visits under each of the following…

[Tics in children and adolescents: a retrospective analysis of 78 cases].

PubMed

Catarina Prior, A; Tavares, S; Figueiroa, S; Temudo, T

2007-02-01

Tics are the most frequent abnormal movement in children. A familial history of tics and a personal and familial history of neurobehavioral disturbances are common in children with this abnormality. Tics may seriously compromise daily activities in affected individuals. To identify the characteristics of tics in children and adolescents followed-up in the Neuropediatric Unit of the Hospital Geral de Santo António. We performed a retrospective analysis of patients with tics based on information collected from medical records. The diagnostic criteria of the DSM IV-TR 2000 of the American Psychiatric Association were used. The medical records of 78 children were analyzed, 84.6 % of whom were boys. More than one third of the patients were aged 4 to 8 years old. In 5.1 % of the patients tics developed before the age of 2 years. A familial history of tics, depression and obsessive disorder traits was found in approximately 30 % of patients. The most frequent comorbidity was attention deficit hyperactivity disorder (67.9 %). The occurrence of pediatric autoimmune neuropsychiatric disorders associated with streptococcus infection (PANDAS) was suggested in five patients. In all patients, motor tics occurred before vocal tics. In more than two thirds of the patients, tics were simple. In 59.0 % of the patients, tics were chronic, and in 45.7 % of these met the criteria for Tourette's syndrome. A total of 43.1 % of the patients with chronic tics received pharmacotherapy, risperidone being the most frequently used drug. In general the results of the present study are in agreement with those of previous studies, underlining the need to consider a diagnosis of tics in young children and highlighting the importance of identification and appropriate treatment of comorbidities.

Recrystallization behavior and thermal shock resistance of the W-1.0 wt% TaC alloy

NASA Astrophysics Data System (ADS)

Xie, Z. M.; Miao, S.; Zhang, T.; Liu, R.; Wang, X. P.; Fang, Q. F.; Hao, T.; Zhuang, Z.; Liu, C. S.; Lian, Y. Y.; Liu, X.; Cai, L. H.

2018-04-01

The high-temperature stability and good mechanical strength of tungsten (W) alloys are highly desirable for a wide range of fusion applications, which can be achieved by dispersion strengthening. In this paper, TaC dispersion effects on the thermal stabilities, tensile properties and thermal shock resistances have been investigated. A hot-rolled W-1.0 wt% TaC plate has been fabricated which contains the high tensile strength and elongation. Nanosized particles in the W matrix improve the recrystallization temperature to about 1400 °C and the ultimate tensile strength to 571 MPa at 500 °C through hindering grain boundary migration, pinning dislocations and refining grains. The effects of edge-localized mode like transient heat events on the rolled and recrystallized W-1.0 wt% TaC alloys were investigated systematically. The cracking threshold (100 shots) at room temperature is in the range of 0.33-0.44 GW/m2 for the rolled W-1.0 wt% TaC. Recrystallization degrades mechanical strength and makes the material more prone to thermal shock damages. Coarse Ta2O5 and Ta-Cx-Oy particles are easy to fracture and introduce a preferential crack initiation in W matrix during cyclic heat loads.

The adsorption and dissociation of O2 on Pd and Pt modified TaC (1 0 0) surface: A first principles study

NASA Astrophysics Data System (ADS)

Meng, Yanan; Zhang, Xilin; Mao, Jianjun; Xu, Xiaopei; Yang, Zongxian

2018-05-01

The adsorption and dissociation of O2 on the palladium and platinum modified TaC (1 0 0) surfaces were investigated based on the density functional theory calculations. It is found that the adsorption sites of O2 are the Ta-Ta bridge sites on both the partially covered TaC (1 0 0) surfaces by Pd and Pt, M4/TaC (1 0 0) (M = Pd and Pt), while the 4-fold metal hollow sites and the metal-metal bridge sites are preferred on the fully covered TaC (1 0 0) surfaces by Pd and Pt monolayer, MML/TaC (1 0 0), respectively. The deposition of Pd or Pt can enhance the oxidation resistance of TaC (1 0 0). Meanwhile, the TaC (1 0 0) decorated by monolayer Pd still exhibited outstanding catalytic activity for O2 dissociation. Our study might be useful to designing efficient catalysts for the oxygen reduction reaction.

The Microwave-Assisted Green Synthesis of TiC Powders.

PubMed

Wang, Hui; Zhu, Wencheng; Liu, Yanchun; Zeng, Lingke; Sun, Luyi

2016-11-08

Titanium carbide (TiC) is an important engineering material and has found widespread applications. Currently, TiC is typically synthesized through carbothermal reduction, requiring a high temperature (ca. 1700-2300 °C) and long reaction time (ca. 10-20 h), which is not eco-friendly. During a conventional reaction path, anatase TiO₂ (A-TiO₂) was first converted to rutile TiO₂ (R-TiO₂), which was subsequently reduced to TiC. Herein, we explored the synthesis of TiC powders with the assistance of microwave heating. In particular, we achieved the conversion of A-TiO₂, which was more reactive than R-TiO₂ for the carbothermal reduction, to TiC, which was directly due to quick microwave heating. As such, the carbothermal reduction started at a much lower temperature of ca. 1200 °C and finished within 30 min when reacting at 1400 °C, leading to significant energy saving. This study shows that microwave-assisted synthesis can be an effective and green process for preparing TiC powders, which is promising for future large-scale production. The influence of the reaction temperature, the reaction duration, and the carbon content on the synthesis of TiC powders was investigated.

From tails to toes: developing nonlethal tissue indicators of mercury exposure in five amphibian species.

PubMed

Pfleeger, Adam Z; Eagles-Smith, Collin A; Kowalski, Brandon M; Herring, Garth; Willacker, James J; Jackson, Allyson K; Pierce, John R

2016-04-01

Exposure to environmental contaminants has been implicated as a factor in global amphibian decline. Mercury (Hg) is a particularly widespread contaminant that biomagnifies in amphibians and can cause a suite of deleterious effects. However, monitoring contaminant exposure in amphibian tissues may conflict with conservation goals if lethal take is required. Thus, there is a need to develop non-lethal tissue sampling techniques to quantify contaminant exposure in amphibians. Some minimally invasive sampling techniques, such as toe-clipping, are common in population-genetic research, but it is unclear if these methods can adequately characterize contaminant exposure. We examined the relationships between mercury (Hg) concentrations in non-lethally sampled tissues and paired whole-bodies in five amphibian species. Specifically, we examined the utility of three different tail-clip sections from four salamander species and toe-clips from one anuran species. Both tail and toe-clips accurately predicted whole-body THg concentrations, but the relationships differed among species and the specific tail-clip section or toe that was used. Tail-clips comprised of the distal 0-2 cm segment performed the best across all salamander species, explaining between 82 and 92% of the variation in paired whole-body THg concentrations. Toe-clips were less effective predictors of frog THg concentrations, but THg concentrations in outer rear toes accounted for up to 79% of the variability in frog whole-body THg concentrations. These findings suggest non-lethal sampling of tails and toes has potential applications for monitoring contaminant exposure and risk in amphibians, but care must be taken to ensure consistent collection and interpretation of samples.

Corticostriatal Divergent Function in Determining the Temporal and Spatial Properties of Motor Tics.

PubMed

Israelashvili, Michal; Bar-Gad, Izhar

2015-12-16

Striatal disinhibition leads to the formation of motor tics resembling those expressed during Tourette syndrome and other tic disorders. The spatial properties of these tics are dependent on the location of the focal disinhibition within the striatum; however, the factors affecting the temporal properties of tic expression are still unknown. Here, we used microstimulation within the motor cortex of freely behaving rats before and after striatal disinhibition to explore the factors underlying the timing of individual tics. Cortical activation determined the timing of individual tics via an accumulation process of inputs that was dependent on the frequency and amplitude of the inputs. The resulting tics and their neuronal representation within the striatum were highly stereotypic and independent of the cortical activity properties. The generation of tics was limited by absolute and relative tic refractory periods that were derived from an internal striatal state. Thus, the precise time of the tic expression depends on the interaction between the summation of incoming excitatory inputs to the striatum and the timing of the previous tic. A data-driven computational model of corticostriatal function closely replicated the temporal properties of tic generation and enabled the prediction of tic timing based on incoming cortical activity and tic history. These converging experimental and computational findings suggest a clear functional dichotomy within the corticostriatal network, pointing to disparate temporal (cortical) versus spatial (striatal) encoding. Thus, the abnormal striatal inhibition typical of Tourette syndrome and other tic disorders results in tics due to cortical activation of the abnormal striatal network. The factors underlying the temporal properties of tics expressed in Tourette syndrome and other tic disorders have eluded clinicians and scientists for decades. In this study, we highlight the key role of corticostriatal activity in determining the

Handwriting Tics in Tourette’s Syndrome: A Single Center Study

PubMed Central

Zanaboni Dina, Carlotta; Bona, Alberto R.; Zekaj, Edvin; Servello, Domenico; Porta, Mauro

2016-01-01

Tourette’s syndrome (TS) is a neurodevelopmental disorder typically defined by multiple motor tics and at least one sound tic, beginning in childhood or in adolescence. Handwriting is one of the most impaired school activities for TS patients because of the presence of tics that hamper learning processes. In this paper, we present a case of handwriting tics in a TS patient highlighting the main features. PMID:26924993

Premonitory urges and tics in Tourette syndrome: computational mechanisms and neural correlates.

PubMed

Conceição, Vasco A; Dias, Ângelo; Farinha, Ana C; Maia, Tiago V

2017-10-01

Tourette syndrome is characterized by open motor behaviors - tics - but another crucial aspect of the disorder is the presence of premonitory urges: uncomfortable sensations that typically precede tics and are temporarily alleviated by tics. We review the evidence implicating the somatosensory cortices and the insula in premonitory urges and the motor cortico-basal ganglia-thalamo-cortical loop in tics. We consider how these regions interact during tic execution, suggesting that the insula plays an important role as a nexus linking the sensory and emotional character of premonitory urges with their translation into tics. We also consider how these regions interact during tic learning, integrating the neural evidence with a computational perspective on how premonitory-urge alleviation reinforces tics. Copyright © 2017 Elsevier Ltd. All rights reserved.

Novel Psychological Formulation and Treatment of “Tic Attacks” in Tourette Syndrome

PubMed Central

Robinson, Sally; Hedderly, Tammy

2016-01-01

One important, but underreported, phenomenon in Tourette syndrome (TS) is the occurrence of “tic attacks.” These episodes have been described at conferences as sudden bouts of tics and/or functional tic-like movements, lasting from 15 min to several hours. They have also been described by patients in online TS communities. To date, there are no reports of tic attacks in the literature. The aim of this article is to stimulate discussion and inform clinical practices by describing the clinical presentation of 12 children (mean age 11 years and 3 months; SD = 2 years and 4 months) with TS and tic attacks, with a detailed case report for one case (13-year-old male). These children commonly present acutely to casualty departments and undergo unnecessary medical investigations. Interestingly, all children reported comorbid anxiety, with worries about the tics themselves and an increased internal focus of attention on tics once the attacks had started. In keeping with other children, the index case reported a strong internal focus of attention, with a relationship between physiological sensations/tic urges, worries about having tic attacks, and behavioral responses (e.g., body scanning, situational avoidance, and other responses). In our experience, the attacks reduce with psychological therapy, for example, the index case attended 13 sessions of therapy that included metacognitive and attention training techniques, as well as cognitive–behavioral strategies. Following treatment, an improvement was seen across a range of measures assessing tics, mood, anxiety, and quality of life. Thus, psychological techniques used to treat anxiety disorders are effective at supporting a reduction in tic attacks through modifying attention, worry processes, and negative beliefs. It is hypothesized that an attentional style of threat monitoring, difficulties tolerating internal sensory urges, cognitive misattributions, and maladaptive coping strategies contribute to

In-toeing in children with type I osteogenesis imperfecta: an observational descriptive study.

PubMed

Losa Iglesias, Marta Elena; Becerro de Bengoa Vallejo, Ricardo; Salvadores Fuentes, Paloma

2009-01-01

Osteogenesis imperfecta is an autosomal-dominant disorder of the connective tissue. Also known as brittle bone disease, it renders those affected susceptible to fractures after minimal trauma. Therefore, it is important to minimize the risk of falls and subsequent fractures in patients with this disease. In-toeing is a common condition in children that can result from various pathologic entities, including anteversion, internal tibial torsion, and metatarsus adductus. These conditions can result in frequent tripping and other functional problems. A descriptive study was undertaken to determine the prevalence of in-toeing gait attributable to tibial or femoral torsion or metatarsus adductus in children with type I osteogenesis imperfecta. The study involved orthopedic and biomechanical examination of 15 children (9 girls and 6 boys) aged 4 to 9 years with confirmed type I osteogenesis imperfecta. Patients who used assistive ambulatory devices, such as canes, crutches, and wheelchairs, were excluded from the study. Of the 15 children studied, 12 (80%) demonstrated previously undiagnosed in-toeing gait attributable to torsional deformity or metatarsus adductus in all but one child. Many children with confirmed type I osteogenesis imperfecta have in-toeing gait caused by torsional deformity or metatarsus adductus. Detection and control of in-toeing gait in children with osteogenesis imperfecta is important to prevent fractures resulting from trauma directly related to these conditions.

Social behavior and comorbidity in children with tics.

PubMed

Pringsheim, Tamara; Hammer, Tracy

2013-12-01

To examine the characteristics of children with coexisting tics and autism spectrum disorder and determine if children with tics have deficits in social behavior. Descriptive study of children referred for tics over 18 months. Parents completed the Social Responsiveness Scale and the Social Communications Questionnaire; children screening positive on these measures were evaluated for autism spectrum disorder. Characteristics of children who were diagnosed with both disorders are described. Subscales scores on the Social Responsiveness Scale for children with tics without a comorbid autism spectrum disorder were compared. The relationship between a comorbid diagnosis of attention deficit hyperactivity disorder and autism spectrum disorder symptoms was explored using logistic and linear regression. One hundred and fourteen children were evaluated. Children with a tic disorder and autism spectrum disorder had significantly higher rates of comorbid attention deficit hyperactivity disorder (P = 0.005), rage attacks (P = 0.006), and oppositional defiant disorder (P = 0.007) than children without autism spectrum disorder. Mean tic severity and treatment rates did not differ between groups. Mean subscale scores on the Social Responsiveness Scale for children without autism spectrum disorders fell into the clinically significant range for autistic mannerisms only. All Social Responsiveness Scale scores were significantly increased by an attention deficit hyperactivity disorder diagnosis (P < 0.0001). Children referred for assessment of tics should be screened for autism spectrum disorders. There is a subgroup of children with multiple neuropsychiatric comorbidities who suffer from social dysfunction and autistic mannerisms outside of an autism spectrum disorder diagnosis. Copyright © 2013 Elsevier Inc. All rights reserved.

Psychopathology in a Swedish population of school children with tic disorders.

PubMed

Khalifa, Najah; von Knorring, Anne-Liis

2006-11-01

To examine patterns of psychiatric comorbid disorders and associated problems in a school population of children with tic disorders. From a total population of 4,479 children, 25 with Tourette's disorder (TD), 34 with chronic motor tics (CMT), 24 with chronic vocal tics (CVT), and 214 with transient tics (TT) during the past year were found. A three-stage procedure was used: tic screening, telephone interview, and clinical assessment. The TD group was compared with 25 children with TT and 25 controls without tics. Psychiatric comorbid disorders were found in 92% of the children with TD. Attention-deficit/hyperactivity disorder was most common, and patterns of psychiatric comorbidity were similar in children with TD and CVT, but not with CMT and TT. Aggressive behavior was more common in children with TD than other tic disorders. Psychiatric comorbid disorders are common even in community-based samples of children with TD and CVT. TD and CVT seem to be part of the same disease entity, with TD being a more severe form. Chronic tics may be a marker for behavioral and learning difficulties in children, and awareness of these associations is critical to the care and treatment of children with tics.

The neural circuits that generate tics in Tourette's syndrome.

PubMed

Wang, Zhishun; Maia, Tiago V; Marsh, Rachel; Colibazzi, Tiziano; Gerber, Andrew; Peterson, Bradley S

2011-12-01

The purpose of this study was to examine neural activity and connectivity within cortico-striato-thalamo-cortical circuits and to reveal circuit-based neural mechanisms that govern tic generation in Tourette's syndrome. Functional magnetic resonance imaging data were acquired from 13 individuals with Tourette's syndrome and 21 healthy comparison subjects during spontaneous or simulated tics. Independent component analysis with hierarchical partner matching was used to isolate neural activity within functionally distinct regions of cortico-striato-thalamo-cortical circuits. Granger causality was used to investigate causal interactions among these regions. The Tourette's syndrome group exhibited stronger neural activity and interregional causality than healthy comparison subjects throughout all portions of the motor pathway, including the sensorimotor cortex, putamen, pallidum, and substantia nigra. Activity in these areas correlated positively with the severity of tic symptoms. Activity within the Tourette's syndrome group was stronger during spontaneous tics than during voluntary tics in the somatosensory and posterior parietal cortices, putamen, and amygdala/hippocampus complex, suggesting that activity in these regions may represent features of the premonitory urges that generate spontaneous tic behaviors. In contrast, activity was weaker in the Tourette's syndrome group than in the healthy comparison group within portions of cortico-striato-thalamo-cortical circuits that exert top-down control over motor pathways (the caudate and anterior cingulate cortex), and progressively less activity in these regions accompanied more severe tic symptoms, suggesting that faulty activity in these circuits may result in their failure to control tic behaviors or the premonitory urges that generate them. Our findings, taken together, suggest that tics are caused by the combined effects of excessive activity in motor pathways and reduced activation in control portions of cortico

Moderators and predictors of response to behavior therapy for tics in Tourette syndrome

PubMed Central

Woods, Douglas W.; Piacentini, John; Wilhelm, Sabine; Peterson, Alan L.; Katsovich, Lily; Dziura, James; Walkup, John T.; Scahill, Lawrence

2017-01-01

Objective: To examine moderators and predictors of response to behavior therapy for tics in children and adults with Tourette syndrome and chronic tic disorders. Methods: Data from 2 10-week, multisite studies (1 in children and 1 in adults; total n = 248) comparing comprehensive behavioral intervention for tics (CBIT) to psychoeducation and supportive therapy (PST) were combined for moderator analyses. Participants (177 male, 71 female) had a mean age of 21.5 ± 13.9 years (range 9–69). Demographic and clinical characteristics, baseline tic-suppressing medication, and co-occurring psychiatric disorders were tested as potential moderators for CBIT vs PST or predictors of outcome regardless of treatment assignment. Main outcomes measures were the Yale Global Tic Severity Scale Total Tic score and the Clinical Global Impression–Improvement score assessed by masked evaluators. Results: The presence of tic medication significantly moderated response to CBIT vs PST (p = 0.01). Participants showed tic reduction after CBIT regardless of tic medication status, but only participants receiving tic medication showed reduction of tics after PST. Co-occurring psychiatric disorders, age, sex, family functioning, tic characteristics, and treatment expectancy did not moderate response. Across both treatments, greater tic severity (p = 0.005) and positive participant expectancy (p = 0.01) predicted greater tic improvement. Anxiety disorders (p = 0.042) and premonitory urge severity (p = 0.005) predicted lower tic reduction. Conclusions: Presence of co-occurring attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, or anxiety disorders did not moderate response to CBIT. Although participants on tic medication showed improvement after CBIT, the difference between CBIT and PST was greater for participants who were not on tic-suppressing medication. ClinicalTrials.gov identifiers: The child and adult CBIT studies are listed on clinical trials.gov (NCT00218777 and

Moderators and predictors of response to behavior therapy for tics in Tourette syndrome.

PubMed

Sukhodolsky, Denis G; Woods, Douglas W; Piacentini, John; Wilhelm, Sabine; Peterson, Alan L; Katsovich, Lily; Dziura, James; Walkup, John T; Scahill, Lawrence

2017-03-14

To examine moderators and predictors of response to behavior therapy for tics in children and adults with Tourette syndrome and chronic tic disorders. Data from 2 10-week, multisite studies (1 in children and 1 in adults; total n = 248) comparing comprehensive behavioral intervention for tics (CBIT) to psychoeducation and supportive therapy (PST) were combined for moderator analyses. Participants (177 male, 71 female) had a mean age of 21.5 ± 13.9 years (range 9-69). Demographic and clinical characteristics, baseline tic-suppressing medication, and co-occurring psychiatric disorders were tested as potential moderators for CBIT vs PST or predictors of outcome regardless of treatment assignment. Main outcomes measures were the Yale Global Tic Severity Scale Total Tic score and the Clinical Global Impression-Improvement score assessed by masked evaluators. The presence of tic medication significantly moderated response to CBIT vs PST ( p = 0.01). Participants showed tic reduction after CBIT regardless of tic medication status, but only participants receiving tic medication showed reduction of tics after PST. Co-occurring psychiatric disorders, age, sex, family functioning, tic characteristics, and treatment expectancy did not moderate response. Across both treatments, greater tic severity ( p = 0.005) and positive participant expectancy ( p = 0.01) predicted greater tic improvement. Anxiety disorders ( p = 0.042) and premonitory urge severity ( p = 0.005) predicted lower tic reduction. Presence of co-occurring attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, or anxiety disorders did not moderate response to CBIT. Although participants on tic medication showed improvement after CBIT, the difference between CBIT and PST was greater for participants who were not on tic-suppressing medication. The child and adult CBIT studies are listed on clinical trials.gov (NCT00218777 and NCT00231985, respectively). This study provides Class I evidence that

Meta-Cognitions in Tourette Syndrome, Tic Disorders, and Body-Focused Repetitive Disorder

PubMed Central

O’Connor, Kieron; St-Pierre-Delorme, Marie-Ève; Leclerc, Julie; Lavoie, Marc; Blais, Mélodie T

2014-01-01

Objective To explore if self-reported presence of thinking about tics or body-focused repetitive behaviours (BFRBs; gests) are direct triggers of tic or gest onset in 3 groups: Tourette syndrome (TS; n =18), persistent chronic tic disorders (TDs; n = 42), and a comparison group with BFRB (n = 36). Method: The 3 groups completed a thinking about tics inventory, listing 22 items derived from clinician consensus that asked whether thoughts always, sometimes, or never exclusively triggered tic onset. Other questionnaires measured mood, perfectionism, impulsivity, premonitory urge, and self-rated tension. Sixty-three participants completed the inventory twice, and the inventory was completed pre- and post-behavioural intervention by a further 54. Results: The ranking of the thoughts reported as likely to trigger tics or gests was positively correlated across TD and BFRB groups. Exploratory principal components analysis of a reduced 12-item set (the thinking about tics inventory) in TS and TD groups revealed that such thoughts could be grouped into 3 separate subscales: thoughts about the interference of tics or gests, thoughts anticipating tics or gests, and thoughts about whether the person has permission to perform the tic or the gest. The 3 sets of subscales showed good and acceptable internal consistency and overall score showed good test–retest reliability, suggesting thoughts about tics or gests are robust and measurable. The subscales correlated with impulsivity, tic or behaviour severity, and ratings of frequency decreased post-behavioural treatment. Conclusions: Thinking about tics or gests is reported as triggering tics or gests in both TD and BFRB, and meta-cognition seems independent of premonitory sensations and relates to distinct clinical characteristics in each clinical group. PMID:25161066

Meta-cognitions in tourette syndrome, tic disorders, and body-focused repetitive disorder.

PubMed

O'Connor, Kieron; St-Pierre-Delorme, Marie-Ève; Leclerc, Julie; Lavoie, Marc; Blais, Mélodie T

2014-08-01

To explore if self-reported presence of thinking about tics or body-focused repetitive behaviours (BFRBs; gests) are direct triggers of tic or gest onset in 3 groups: Tourette syndrome (TS; n =18), persistent chronic tic disorders (TDs; n = 42), and a comparison group with BFRB (n = 36). The 3 groups completed a thinking about tics inventory, listing 22 items derived from clinician consensus that asked whether thoughts always, sometimes, or never exclusively triggered tic onset. Other questionnaires measured mood, perfectionism, impulsivity, premonitory urge, and self-rated tension. Sixty-three participants completed the inventory twice, and the inventory was completed pre- and post-behavioural intervention by a further 54. The ranking of the thoughts reported as likely to trigger tics or gests was positively correlated across TD and BFRB groups. Exploratory principal components analysis of a reduced 12-item set (the thinking about tics inventory) in TS and TD groups revealed that such thoughts could be grouped into 3 separate subscales: thoughts about the interference of tics or gests, thoughts anticipating tics or gests, and thoughts about whether the person has permission to perform the tic or the gest. The 3 sets of subscales showed good and acceptable internal consistency and overall score showed good test-retest reliability, suggesting thoughts about tics or gests are robust and measurable. The subscales correlated with impulsivity, tic or behaviour severity, and ratings of frequency decreased post-behavioural treatment. Thinking about tics or gests is reported as triggering tics or gests in both TD and BFRB, and meta-cognition seems independent of premonitory sensations and relates to distinct clinical characteristics in each clinical group.

Treatment strategies for tics in Tourette syndrome

PubMed Central

Eddy, Clare M.; Rickards, Hugh E.; Cavanna, Andrea E.

2011-01-01

Tourette syndrome (TS) is a chronic neurodevelopmental disorder characterized by tics: repetitive, involuntary movements and vocalizations. These symptoms can have a significant impact on patients’ daily functioning across many domains. Tics tend to be most severe in child and adolescent sufferers, so their presence has the potential to impact a period of life that is both critical for learning and is often associated with the experience of greater social tension and self-consciousness than adulthood. Furthermore, control over tics that lead to physical impairment or self-injurious behaviour is of vital importance in maintaining health and quality of life. There are numerous complicating factors in the prescription of treatment for tics, due to both the side effects associated with alleviating agents and patient characteristics, such as age and comorbid conditions. This review summarizes literature pertaining to the efficacy and safety of both traditionally prescribed and more modern medications. We also discuss the merits of behavioural and surgical techniques and highlight newer emerging treatments. Although treatment response is to some extent variable, there are a number of agents that are clearly useful as first-line treatments for TS. Other interventions may be of most benefit to patients exhibiting refractory tics or more specific symptom profiles. PMID:21339906

[Microsurgical 2nd toe transfer for catastrophic hand reconstruction].

PubMed

Placer, A; Lozano, Ja

2007-01-01

The correct reconstruction of the catastrophic hand requires complex surgical techniques. The microsurgical transference of a toe is indicated when all other reconstructive options are shown to be useless for the reconstruction of the required clamp function. In this clinical note we set out the case of a 32 year old man, who came to our accident and emergency department after suffering a traffic accident. After exploration the diagnosis was that of catastrophic left hand, among other policontusions. Urgent surgery was carried out, saving the maximum possible viable structures. The immediate result of this surgery was a hand with 1st, 4th and 5th functional fingers. As the essential clamp function between the 1st and 4th or 5th fingers was not totally satisfactory, we decided to reconstruct the 3rd finger of his hand with his ipsilateral 2nd toe. All pertinent studies to determine vascularisation of the flap were carried out in planning the surgery, and the microsurgical transfer was then realized, which was successful. Today, after a suitable rehabilitation, the patient has recovered a satisfactory function of heavy and fine clamp in the operated hand. Toe to hand transfer is a good option for finger reconstruction and its function. Rehabilitation is the key to functional recovery.

Prolonged striatal disinhibition as a chronic animal model of tic disorders.

PubMed

Vinner, Esther; Israelashvili, Michal; Bar-Gad, Izhar

2017-12-01

Experimental findings and theoretical models have associated Tourette syndrome with abnormal striatal inhibition. The expression of tics, the hallmark symptom of this disorder, has been transiently induced in non-human primates and rodents by the injection of GABA A antagonists into the striatum, leading to temporary disinhibition. The novel chronic model of tic expression utilizes mini-osmotic pumps implanted subcutaneously in the rat's back for prolonged infusion of bicuculline into the dorsolateral striatum. Tics were expressed on the contralateral side to the infusion over a period of multiple days. Tic expression was stable, and maintained similar properties throughout the infusion period. Electrophysiological recordings revealed the existence of tic-related local field potential spikes and individual neuron activity changes that remained stable throughout the infusion period. The striatal disinhibition model provides a unique combination of face validity (tic expression) and construct validity (abnormal striatal inhibition) but is limited to sub-hour periods. The new chronic model extends the period of tic expression to multiple days and thus enables the study of tic dynamics and the effects of behavior and pharmacological agents on tic expression. The chronic model provides similar behavioral and neuronal correlates of tics as the acute striatal disinhibition model but over prolonged periods of time, thus providing a unique, basal ganglia initiated model of tic expression. Chronic expression of symptoms is the key to studying the time varying properties of Tourette syndrome and the effects of multiple internal and external factors on this disorder. Copyright © 2017 Elsevier B.V. All rights reserved.

The neural correlates of tic inhibition in Gilles de la Tourette syndrome.

PubMed

Ganos, Christos; Kahl, Ursula; Brandt, Valerie; Schunke, Odette; Bäumer, Tobias; Thomalla, Götz; Roessner, Veit; Haggard, Patrick; Münchau, Alexander; Kühn, Simone

2014-12-01

Tics in Gilles de la Tourette syndrome (GTS) resemble fragments of normal motor behaviour but appear in an intrusive, repetitive and context-inappropriate manner. Although tics can be voluntarily inhibited on demand, the neural correlates of this process remain unclear. 14 GTS adults without relevant comorbidities participated in this study. First, tic severity and voluntary tic inhibitory capacity were evaluated outside the scanner. Second, patients were examined with resting state functional magnetic resonance imaging (RS-fMRI) in two states, free ticcing and voluntary tic inhibition. Local synchronization of spontaneous fMRI-signal was analysed with regional homogeneity (ReHo) and differences between both states (free ticcing<tic inhibition) were contrasted. Clinical correlations of the resulting differential ReHo parameters between both states and clinical measures of tic frequency, voluntary tic inhibition and premonitory urges were also performed. ReHo of the left inferior frontal gyrus (IFG) was increased during voluntary tic inhibition compared to free ticcing. ReHo increases were positively correlated with participants׳ ability to inhibit their tics during scanning sessions but also outside the scanner. There was no correlation with ratings of premonitory urges. Voluntary tic inhibition is associated with increased ReHo of the left IFG. Premonitory urges are unrelated to this process. Copyright © 2014 Elsevier Ltd. All rights reserved.

Psychopathology in a Swedish Population of School Children with Tic Disorders

ERIC Educational Resources Information Center

Khalifa, Najah; Von Knorring, Anne-Liis

2006-01-01

Objective: To examine patterns of psychiatric comorbid disorders and associated problems in a school population of children with tic disorders. Method: From a total population of 4,479 children, 25 with Tourette's disorder (TD), 34 with chronic motor tics (CMT), 24 with chronic vocal tics (CVT), and 214 with transient tics (TT) during the past…

Computer Assistance for Writing Interactive Programs: TICS.

ERIC Educational Resources Information Center

Kaplow, Roy; And Others

1973-01-01

Investigators developed an on-line, interactive programing system--the Teacher-Interactive Computer System (TICS)--to provide assistance to those who were not programers, but nevertheless wished to write interactive instructional programs. TICS had two components: an author system and a delivery system. Underlying assumptions were that…

From tails to toes: developing nonlethal tissue indicators of mercury exposure in five amphibian species

USGS Publications Warehouse

Pfleeger, Adam Z.; Eagles-Smith, Collin A.; Kowalski, Brandon M.; Herring, Garth; Willacker, James J.; Jackson, Allyson K.; Pierce, John

2016-01-01

Exposure to environmental contaminants has been implicated as a factor in global amphibian decline. Mercury (Hg) is a particularly widespread contaminant that biomagnifies in amphibians and can cause a suite of deleterious effects. However, monitoring contaminant exposure in amphibian tissues may conflict with conservation goals if lethal take is required. Thus, there is a need to develop non-lethal tissue sampling techniques to quantify contaminant exposure in amphibians. Some minimally invasive sampling techniques, such as toe-clipping, are common in population-genetic research, but it is unclear if these methods can adequately characterize contaminant exposure. We examined the relationships between mercury (Hg) concentrations in non-lethally sampled tissues and paired whole-bodies in five amphibian species. Specifically, we examined the utility of three different tail-clip sections from four salamander species and toe-clips from one anuran species. Both tail and toe-clips accurately predicted whole-body THg concentrations, but the relationships differed among species and the specific tail-clip section or toe that was used. Tail-clips comprised of the distal 0–2 cm segment performed the best across all salamander species, explaining between 82 and 92 % of the variation in paired whole-body THg concentrations. Toe-clips were less effective predictors of frog THg concentrations, but THg concentrations in outer rear toes accounted for up to 79 % of the variability in frog whole-body THg concentrations. These findings suggest non-lethal sampling of tails and toes has potential applications for monitoring contaminant exposure and risk in amphibians, but care must be taken to ensure consistent collection and interpretation of samples.

Temporal relationship between premonitory urges and tics in Gilles de la Tourette syndrome.

PubMed

Brandt, Valerie C; Beck, Christian; Sajin, Valeria; Baaske, Magdalena K; Bäumer, Tobias; Beste, Christian; Anders, Silke; Münchau, Alexander

2016-04-01

Premonitory urges are a cardinal feature in Tourette syndrome and are commonly viewed as the driving force of tics, building up before and subsiding after the execution of tics. Although the urge-tic interplay is one of the most preeminent features in Tourette syndrome, the temporal relationship between tics and urges has never been examined experimentally, mainly due to the lack of an appropriate assessment tool. We investigated the temporal relationship between urge intensity and tics in 17 Tourette patients and between urge intensity and eye blinks in 16 healthy controls in a free ticcing/blinking condition and a tic/blink suppression condition. For this purpose, an urge assessment tool was developed that allows real-time monitoring and quantification of urge intensity. Compared to free ticcing/blinking, urge intensity was higher during the suppression condition in both Tourette patients and healthy controls, while tics and blinks occurred less frequently. The data show that urge intensity increases prior to tics and decreases after tics in a time window of approximately ±10 sec. Tic suppression had a significant effect on the shape of the urge distribution around tics and led to a decrease in the size of the correlation between urge intensity and tics, indicating that tic suppression led to a de-coupling of tics and urges. In healthy controls, urges to blink were highly associated with eye blink execution, albeit in a narrower time frame (∼±5 sec). Blink suppression had a similar effect on the urge distribution associated with eye blinks as tic suppression had on the urge to tic in Tourette patients. These results corroborate the negative reinforcement model, which proposes that tics are associated with a relief in urges, thereby perpetuating ticcing behaviour. This study also documents similarities and differences between urges to act in healthy controls and urges to tic in Tourette syndrome. Copyright © 2016 Elsevier Ltd. All rights reserved.

Relationships between Premonitory Urge and Anxiety in Youth with Chronic Tic Disorders.

PubMed

Rozenman, Michelle; Johnson, Olivia E; Chang, Susanna W; Woods, Douglas W; Walkup, John T; Wilhelm, Sabine; Peterson, Alan; Scahill, Lawrence; Piacentini, John

2015-07-01

Tourette's Disorder and other chronic tic disorders are common neurodevelopmental conditions. One characteristic of tic disorders is the premonitory urge, an aversive or unpleasant sensory phenomenon that may precede tics. Initial examination of premonitory urge in pediatric tic disorders suggests that awareness and experience of sensations preceding tics may be related to anxiety and OCD. However, it may be possible that specific anxiety-related symptoms, such as anxious physiologic arousal, are particularly relevant to the experience of premonitory urge. The current study examines relationships between tic-related premonitory urge and anxiety-related symptom clusters in treatment-seeking youths with a primary diagnoses of Tourette's or other chronic tic disorder. The sample consisted of 124 youth, ages 9 to 17, who participated in the multi-site Comprehensive Behavioral Intervention for Tics randomized controlled trial (CBIT; Piacentini et al., 2010). Specific anxiety-related subtypes, including generalized worry, separation, social, and panic/somatic symptoms, as well as severity of obsessions and compulsions, were assessed as potential correlates of premonitory urge. Findings indicated that age, global tic-related impairment, and specific panic/somatic symptoms accounted for a substantial proportion of variance in youth report of premonitory urge. These findings provide information about the characteristics of premonitory urge in pediatric tic disorders, and have implications for the treatment of pediatric tic syndromes.

Attention bias for social threat in youth with tic disorders: Links with tic severity and social anxiety.

PubMed

Pile, Victoria; Robinson, Sally; Topor, Marta; Hedderly, Tammy; Lau, Jennifer Y F

2018-06-07

Many individuals with Tourette syndrome and chronic tic disorders (TS/CTDs) report poor social functioning and comorbid social anxiety. Yet limited research has investigated the role of cognitive factors that highlight social threats in youth with TS/CTD, and whether these biases underlie tic severity and co-occurring social anxiety. This study examined whether selective attention to social threat is enhanced young people with TS/CTDs compared to healthy controls, and whether attention biases are associated with tic severity and social anxiety. Twenty seven young people with TS/CTDs and 25 matched control participants completed an experimental measure of attention bias toward/away from threat stimuli. A clinician-rated interview measuring tic severity/impairment (YGTSS Total Score) and questionnaire measures of social anxiety were completed by participants and their parents. Young people with TS/CTD showed an attention bias to social threat words (relative to benign words) compared to controls but no such bias for social threat faces. Attention bias for social threat words was associated with increasing YGTSS Total Score and parent-reported social anxiety in the TS/CTDs group. Mediation analysis revealed a significant indirect path between YGTSS Total Score and social anxiety, via attention to social threat. Tentatively, these associations appeared to be driven by impairment rather than tic severity scores. Preliminary data suggests that youth with TS/CTD have enhanced attention to threat, compared to controls, and this is associated with impairment and social anxiety. Attention to threat could offer a cognitive mechanism connecting impairment and social anxiety, and so be a valuable trans-diagnostic treatment target.

Behavioral therapy for Tourette syndrome and chronic tic disorders

PubMed Central

Woods, Douglas; Ganos, Christos

2017-01-01

Abstract Purpose of review: To summarize behavioral interventions for the treatment of primary tic disorders. Recent findings: Although tics were attributed to a disordered weak volition, the shift towards neurobiological models of tic disorders also transformed nonpharmacologic treatment practices. Current international guidelines recommend habit reversal training, comprehensive behavioral intervention, and exposure and response prevention as first-line therapies for tics. Appropriate patient selection, including age and presence of comorbidities, are salient clinical features that merit consideration. Evidence for further behavioral interventions is also presented. Summary: Currently recommended behavioral interventions view tics as habitual responses that may be further strengthened through negative reinforcement. Although availability and costs related to these interventions may limit their effect, Internet-based and telehealth approaches may facilitate wide accessibility. Novel nonpharmacologic treatments that take different approaches, such as autonomic modulation or attention-based interventions, may also hold therapeutic promise. PMID:29185535

Habit Reversal Training for Tic Disorders in Children and Adolescents

ERIC Educational Resources Information Center

Piacentini, John; Chang, Susanna

2005-01-01

Chronic tic disorders, including Tourette's syndrome (TS), affect approximately .5% of children and adolescents. Although strong evidence exists supporting a neurobiological etiology, operant factors may play a role in the maintenance of tic behaviors. Pharmacological approaches remain the most commonly used intervention for chronic tic disorder…

[Paroxysmal stereotypy-tic-dystonia syndrome].

PubMed

Cabrera-López, J C; Martí-Herrero, M; Fernández-Burriel, M; Toledo-Bravo de Laguna, L; Domínguez-Ramírez, S; Fortea-Sevilla, S

We report the cases of four males from four different families, who presented paroxysmal episodes from the 1st 2nd year. These episodes were characterised by asymmetrical bilateral dystonia of the upper limbs, predominantly in both hands, and were associated with orofacial dyskinesias, stereotipies (jumping, arm flapping, etc.), facial tics and, occasionally, phonic tics. Consciousness is not affected in any of the cases. These movements are triggered in situations where the patient is relaxed or excited. They occur daily and last from a few seconds to 30 minutes. Between the bouts, they remain asymptomatic. Family cases suggest it is inherited by autosomal dominant transmission, perhaps linked to the X chromosome; in addition, two cases are sporadic. In the only adult, the movements progress to a series of rhythmic bilateral dystonic myoclonias and facial tics dyskinesias. All the studies carried out, EEG, hemogram, biochemical analysis, neuroimaging, copper and ceruloplasmin levels, were normal. 1. We report a non epileptic paroxysmal disorder originating in the extrapyramidal tracts with its own characteristics, with onset during early childhood, which is associated with stereotipies, tics and dystonia; 2. It occurs predominantly in males; 3. It is inherited by autosomal dominant transmission, or perhaps sex linked autosomal dominant inheritance, and there are also sporadic cases; 4. The range of clinical features is very wide and includes cases in which there are few symptoms to others where the extent and gravity of the disorder is very significant.

Tic-related school problems: impact on functioning, accommodations, and interventions.

PubMed

Packer, Leslie E

2005-11-01

Children with Tourette's syndrome (TS) are statistically overrepresented in special education classes; however, the extent to which tics contribute to such placement is unclear. In this article, the results of a survey of parents or guardians of 71 children and adolescents with TS are described within the broader context of discussing the impact of tics and educational practices. One half of the respondents reported moderate to significant tic-related academic impact, and 48% reported moderate to significant tic-related peer problems. Peer education and in-school counseling were generally not offered nor provided. In the minority of cases where behavioral interventions for tics were reported, contingent aversive consequences were reported to be ineffective or counterproductive, while positive reinforcement for modifying tics reportedly produced some successful results. The identification of research-validated academic accommodations and increased involvement of school psychologists are suggested as necessary and potentially helpful supports for students with TS and their teachers.

Three Cases of Palatal Tics and Gilles De La Tourette Syndrome.

PubMed

Rizzo, Renata; Cath, Danielle; Pavone, Piero; Tijssen, Marina; Robertson, Mary M

2015-08-01

Five patients with palatal tics and Gilles de la Tourette syndrome have been previously reported. Little is known about the characteristics of palatal tics given that there are so few reports. On one hand, palatal tics may be rare. Alternatively, they may be less well recognized than repetitive eye blinking or sniffing, which are both obvious and, therefore, more often reported. We describe 3 patients with palatal tics and Gilles de la Tourette syndrome. We also review the 5 patients reported in the literature and explore whether there are characteristic features among this group of 8 cases. The 8 patients had the following features: (1) Personal history of other multiple motor/vocal tics, (2) the presence of typical Gilles de la Tourette syndrome comorbidities, (3) positive family history of tics and/or Gilles de la Tourette syndrome comorbidities, (4) the presence of audible "ear clicks," (5) younger age at onset (2 years). We suggest that palatal tics are underreported. © The Author(s) 2014.

Evaluation of a cognitive psychophysiological model for management of tic disorders: an open trial.

PubMed

O'Connor, Kieron; Lavoie, Marc; Blanchet, Pierre; St-Pierre-Delorme, Marie-Ève

2016-07-01

Tic disorders, in particular chronic tic disorder and Tourette syndrome, affect about 1% of the population. The current treatment of choice is pharmacological or behavioural, addressing tics or the premonitory urges preceding tic onset. The current study reports an open trial evaluating the effectiveness of a cognitive psychophysiological treatment addressing Tourette-specific sensorimotor activation processes rather than the tic. Forty-nine people with Tourette syndrome and 36 people with chronic tics completed 10 weeks of individual cognitive psychophysiological therapy. Outcome measures included two tic severity scales and psychosocial measures. Post-treatment both groups had significantly improved on the tic scales with strong effect sizes across tic locations and complex and simple tics, maintained at 6-month follow-up with further change in perfectionism and self-esteem. The cognitive psychophysiological approach targeting underlying sensorimotor processes rather than tics in Tourette's and chronic tic disorder reduced symptoms with a large effect size. © The Royal College of Psychiatrists 2016.

Microstructure Evolution of TiC Particles In Situ, Synthesized by Laser Cladding

PubMed Central

Liu, Yanhui; Ding, Jieqiong; Qu, Weicheng; Su, Yu; Yu, Zhishui

2017-01-01

In this paper, a TiC reinforcement metal matrix composite coating is produced using nickel and graphite mixing powder on the surface ofTi-6Al-4V alloy by laser radiation. The microstructure of the coatings is investigated by XRD, SEM and EDS. Results show that most of the TiC phase is granular, with a size of several micrometers, and a few of the TiC phases are petals or flakes. At the cross-section of the coatings, a few special TiC patterns are found and these TiC patterns do not always occur at the observed cross-section. The even distribution of the TiC phase in the coatings confirms that the convection of the laser-melted pool leads to the homogenization of titanium atoms from the molten substrate, and carbon atoms from the preplace powder layer, by the mass transfer. The characteristics of the TiC pattern confirm that the morphology and distribution of the primary TiC phase could be influenced by convection. Two main reasons for this are that the density of the TiC phase is lower than the liquid melt, and that the primary TiC phase precipitates from the pool with a high convection speed at high temperature. PMID:28772641

Microstructure Evolution of TiC Particles In Situ, Synthesized by Laser Cladding.

PubMed

Liu, Yanhui; Ding, Jieqiong; Qu, Weicheng; Su, Yu; Yu, Zhishui

2017-03-11

In this paper, a TiC reinforcement metal matrix composite coating is produced using nickel and graphite mixing powder on the surface ofTi-6Al-4V alloy by laser radiation. The microstructure of the coatings is investigated by XRD, SEM and EDS. Results show that most of the TiC phase is granular, with a size of several micrometers, and a few of the TiC phases are petals or flakes. At the cross-section of the coatings, a few special TiC patterns are found and these TiC patterns do not always occur at the observed cross-section. The even distribution of the TiC phase in the coatings confirms that the convection of the laser-melted pool leads to the homogenization of titanium atoms from the molten substrate, and carbon atoms from the preplace powder layer, by the mass transfer. The characteristics of the TiC pattern confirm that the morphology and distribution of the primary TiC phase could be influenced by convection. Two main reasons for this are that the density of the TiC phase is lower than the liquid melt, and that the primary TiC phase precipitates from the pool with a high convection speed at high temperature.

Neuronal activity in the globus pallidus internus in patients with tics.

PubMed

Zhuang, P; Hallett, M; Zhang, X; Li, J; Zhang, Y; Li, Y

2009-10-01

To explore the role of neuronal activity in the globus pallidus internus (GPi) in the generation of tic movements. 8 patients with Tourette's syndrome with medically intractable tics who underwent a unilateral pallidotomy for severe tics were studied. They ranged in age from 17 to 24 years; disease duration was 7-19 years. Microelectrode recording was performed in the GPi. The electromyogram (EMG) was simultaneously recorded in muscle groups appropriate for the patient's tics. The relationship between neuronal firing pattern and the EMG was studied. 232 neurons were recorded during tics from eight trajectories. Of these neurons, in addition to decreased neuronal firing rate and irregular firing pattern, 105 (45%) were tic related showing either a burst of activity or a pause in ongoing tonic activity. They could be synchronous (n = 75), earlier than EMG onset (n = 27) or following EMG onset (n = 3). The GPi neuronal bursts preceded EMG onset with decreased (n = 6) or increased activity (n = 21). The initial change in neural activity occurred about 50 ms to 2 s before the EMG onset. Although the data are descriptive and preliminary, the tic related neuronal activity observed in GPi appears to indicate that the basal ganglia motor circuit is involved in tic movements. The early neuronal activity seen in GPi may reflect premonitory sensations that precede a tic.

[Tics and Tourette syndrome in literature, cinema and television].

PubMed

Collado-Vázquez, Susana; Carrillo, Jesús M

2013-08-01

Different neurological diseases have often been portrayed in literature, cinema and television. Tics and Tourette syndrome, for example, are commonly represented from different perspectives, which are sometimes very realistic but in some cases are used for more dramatic purposes or to make a character look ridiculous. One of the main effects of these inadequate views is to further stigmatise those who suffer these movement disorders. To review the way tics and Tourette syndrome have been portrayed in certain literary works, films and television. Tics are rapid, stereotypic, involuntary, recurring, non-purposeful movements of the skeletal and pharyngeal-laryngeal muscles. In Gilles de la Tourette syndrome a number of tics are associated to involuntary vocalisations (echolalia, coprolalia). They begin in childhood and are usually associated to obsessive-compulsive behaviours. These disorders have appeared in literature in works such as Little Dorrit, Angel Guerra, La torre de los siete jorobados or Motherless Brooklyn. Film-makers have also shown an interest in tics and Tourette syndrome and they have been portrayed in films such as Young and Innocent, The Tic Code or Matchstick Men. Likewise, a number of television series also contain characters with these disorders, including Shameless, Ally McBeal, Quincy, M.E. or L.A. Law. Tics and Tourette syndrome have frequently been portrayed in literature, cinema and television, sometimes in a very realistic manner. In other cases, however, the way they are dealt with has only helped to create false beliefs and stereotyped images of the disorders.

A multicenter examination and strategic revisions of the Yale Global Tic Severity Scale.

PubMed

McGuire, Joseph F; Piacentini, John; Storch, Eric A; Murphy, Tanya K; Ricketts, Emily J; Woods, Douglas W; Walkup, John W; Peterson, Alan L; Wilhelm, Sabine; Lewin, Adam B; McCracken, James T; Leckman, James F; Scahill, Lawrence

2018-05-08

To examine the internal consistency and distribution of the Yale Global Tic Severity Scale (YGTSS) scores to inform modification of the measure. This cross-sectional study included 617 participants with a tic disorder (516 children and 101 adults), who completed an age-appropriate diagnostic interview and the YGTSS to evaluate tic symptom severity. The distributions of scores on YGTSS dimensions were evaluated for normality and skewness. For dimensions that were skewed across motor and phonic tics, a modified Delphi consensus process was used to revise selected anchor points. Children and adults had similar clinical characteristics, including tic symptom severity. All participants were examined together. Strong internal consistency was identified for the YGTSS Motor Tic score (α = 0.80), YGTSS Phonic Tic score (α = 0.87), and YGTSS Total Tic score (α = 0.82). The YGTSS Total Tic and Impairment scores exhibited relatively normal distributions. Several subscales and individual item scales departed from a normal distribution. Higher scores were more often used on the Motor Tic Number, Frequency, and Intensity dimensions and the Phonic Tic Frequency dimension. By contrast, lower scores were more often used on Motor Tic Complexity and Interference, and Phonic Tic Number, Intensity, Complexity, and Interference. The YGTSS exhibits good internal consistency across children and adults. The parallel findings across Motor and Phonic Frequency, Complexity, and Interference dimensions prompted minor revisions to the anchor point description to promote use of the full range of scores in each dimension. Specific minor revisions to the YGTSS Phonic Tic Symptom Checklist were also proposed. © 2018 American Academy of Neurology.

Effects of shoe sole geometry on toe clearance and walking stability in older adults.

PubMed

Thies, S B; Price, C; Kenney, L P J; Baker, R

2015-07-01

Thirty-five percent of people above age 65 fall each year, and half of their falls are associated with tripping: tripping, an apparently 'mundane' everyday problem, therefore, significantly impacts on older people's health and associated medical costs. To avoid tripping and subsequent falling, sufficient toe clearance during the swing phase is crucial. We previously found that a rocker-shaped shoe sole enhances toe clearance in young adults, thereby decreasing their trip-risk. This study investigates whether such sole design also enhances older adults' toe clearance, without inadvertently affecting their walking stability. Toe clearance and its variability are reported together with measures of walking stability for twelve older adults, walking in shoes with rocker angles of 10°, 15°, and 20°. Surface inclinations (flat, incline, decline) were chosen to reflect a potential real-world environment. Toe clearance increased substantially from the 10° to the 15° rocker angle (p=0.003) without compromising measures of walking stability (p>0.05). A further increase in rocker angle to 20° resulted in less substantial enhancement of toe clearance and came at the cost of a decrease in gait speed on the decline. The novelty of this investigation lies in the exploration of the trade-off between reduction of trip-risk through footwear design and adverse effects on walking stability on real-life relevant surfaces. Our two studies suggest that the current focus on slip-resistance in footwear design may need to be generalised to include other factors that affect trip-risk. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

[Sociodemographic/Clinical characteristics and risk factors associated with chronic tic disorders].

PubMed

Hesapçıoğlu, Selma Tural; Tural, Mustafa Kemal; Kandil, Sema

2013-01-01

This study aimed to investigate comorbidity, and sociodemographic and clinical characteristics in children and adolescents with Tourette's syndrome (TS) and chronic motor or vocal tic disorder (CMVTD), and to determine the predictors of tic disorders. In all, 57 children and adolescents with TS and CMVTD were compared with a control group. Data were obtained using the Yale Global Tic Severity Scale (YGTSS), Turgay DSM-IV-Based Disruptive Behavioral Disorders Screening and Rating Scale (T-DSM-IV-S), Children's Depression Inventory (CDI), Screen for Child Anxiety-Related Disorders (SCARED), Maudsley Obsessive-Compulsive Inventory (MOCI), and Schedule for Affective Disorders and Schizophrenia for School Age Children-Present and Lifetime Version (K-SADS-PL). Mean age of the patients was 10.5 ± 2.4 years. In all, 56 (98.2%) of the patients had simple motor tics, 50 (87.7%) had complex motor tics, and 43 (75.4%) had vocal tics. Self-injurious behavior was observed in 24 (42.1%) patients. In total, 46 (80.7%) of the patients had ≥1 comorbid disorder. Among the observed comorbid disorders, attention deficit-hyperactivity disorder (ADHD) was the most common (observed in 40.4% of the patients), followed by obsessive-compulsive disorder (OCD) (19.3%). A higher-level of maternal education and absence of ADHD were associated with a reduction in the risk of a tic disorder. A family history of psychiatric disorder increased the risk of a tic disorder 5.61-fold, and nail biting increased the risk of a tic disorder 8.2-fold. Every 1-unit increase in CDI score increased the risk of a tic disorder by 12%. Chronic tic disorders (CTDs) are often accompanied by other psychiatric disorders. Both child- and family-related factors are associated with the risk of developing a tic disorder. Determination of both the protective and risk factors would be beneficial for improving the mental health of the general public.

Intercalary non-vascularised toe phalanx transplantation for short finger-type symbrachydactyly.

PubMed

Kanauchi, Yumiko; Takahara, Masatoshi; Ogino, Toshihiko; Kashiwa, Hideo; Ishigaki, Daisuke

2003-12-01

A two-year-old boy with short finger-type symbrachydactyly involving the index, middle, and ring fingers was treated with intercalary nonvascularised toe phalanx transplantation into the middle finger to obtain stability of the middle finger before syndactyly release. He underwent syndactyly release one year after the transplantation. Two years after the transplantation, the clinical result was satisfactory, although X-ray showed fibrous union between the transplanted phalanx and the host phalanx. Intercalary nonvascularised toe phalanx transplantation is one of the way of stabilising a finger after syndactyly release.

Neuroleptic-induced "painful legs and moving toes" syndrome: successful treatment with clonazepam and baclofen.

PubMed

Sandyk, R

1990-12-01

The syndrome of "painful legs and moving toes" is characterised by spontaneous causalgic pain in the lower extremities associated with peculiar involuntary movements of the toes and feet. It has been observed after a variety of lesions affecting the posterior nerve roots, the spinal ganglia and the peripheral nerves. The pathophysiology of the syndrome is unknown. I report a patient who developed the syndrome during treatment for schizophrenia with the antipsychotic agent molindone hydrochloride. The patient's response to the combination of clonazepam and baclofen suggests that the pathophysiology of the "painful legs and moving toes" may be linked to impairment of spinal serotonergic and GABA functions.

A systematic review of discomfort due to toe or ear clipping in laboratory rodents

PubMed Central

Geessink, Florentine J.; Brouwer, Michelle A. E.; Tillema, Alice; Ritskes-Hoitinga, Merel

2017-01-01

Toe clipping and ear clipping (also ear notching or ear punching) are frequently used methods for individual identification of laboratory rodents. These procedures potentially cause severe discomfort, which can reduce animal welfare and distort experimental results. However, no systematic summary of the evidence on this topic currently exists. We conducted a systematic review of the evidence for discomfort due to toe or ear clipping in rodents. The review methodology was pre-specified in a registered review protocol. The population, intervention, control, outcome (PICO) question was: In rodents, what is the effect of toe clipping or ear clipping, compared with no clipping or sham clipping, on welfare-related outcomes? Through a systematic search in PubMed, Embase, Web of Science and grey literature, we identified seven studies on the effect of ear clipping on animal welfare, and five such studies on toe clipping. Studies were included in the review if they contained original data from an in vivo experiment in rodents, assessing the effect of toe clipping or ear clipping on a welfare-related outcome. Case studies and studies applying unsuitable co-interventions were excluded. Study quality was appraised using an extended version of SYstematic Review Centre for Laboratory animal Experimentation (SYRCLE)’s risk of bias tool for animal studies. Study characteristics and outcome measures were highly heterogeneous, and there was an unclear or high risk of bias in all studies. We therefore present a narrative synthesis of the evidence identified. None of the studies reported a sample size calculation. Out of over 60 different outcomes, we found evidence of discomfort due to ear clipping in the form of increased respiratory volume, vocalization and blood pressure. For toe clipping, increased vocalization and decreased motor activity in pups were found, as well as long-term effects in the form of reduced grip strength and swimming ability in adults. In conclusion, there

Developmental and Behavioral Effects of Toe Clipping on Neonatal and Preweanling Mice with and without Vapocoolant Anesthesia

PubMed Central

Paluch, Lee-Ronn; Lieggi, Christine C; Dumont, Magali; Monette, Sebastien; Riedel, Elyn R; Lipman, Neil S

2014-01-01

Toe clipping is used to identify and genotype preweanling mice, but the procedure generates concerns relevant to pain and distress. The few pertinent studies available evaluated mice between postnatal days (PND) 3 and 7, advocate the use of toe clipping in mice PND 7 or younger, and identify handling as the most distressing aspect of the procedure. Because both toe and tail clipping may be necessary in older mice to obtain sufficient DNA for genotyping, we surmised that performing these procedures concurrently to minimize handling would be beneficial. We also examined reflex development until PND 21 and adult behavior at 8 to 10 wk of age in mice toe clipped at PND 7 or 17 and the benefits of using topical vapocoolant anesthesia. C57BL/6J pups at PND 7 and 17 were assigned to 1 of 4 groups: 1) clipping of digit 3 of contralateral fore- and hindpaws; 2) toe clipping after topical vapocoolant anesthesia; 3) unclipped, unsprayed controls; and, 4) unclipped and vapocoolant-sprayed. Compared with unanesthetized pups, those sprayed with vapocoolant vocalized and struggled more when handled and had more bleeding, erythema, and swelling, which persisted for as long as 12 h after toe clipping. Reflex development, anxiety, locomotion, and motor coordination were not different among groups or with regard to the age of toe clipping. No tissue reaction was noted microscopically in paws collected at 10 wk of age. We conclude that the use of vapocoolant cannot be recommended due to its harmful effects and that toe clipping at PND 7 or 17 does not significantly affect the long-term welfare of mice. PMID:24602538

Reliability and Validity of the Yale Global Tic Severity Scale

ERIC Educational Resources Information Center

Storch, Eric A.; Murphy, Tanya K.; Geffken, Gary R.; Sajid, Muhammad; Allen, Pam; Roberti, Jonathan W.; Goodman, Wayne K.

2005-01-01

To investigate the reliability and validity of the Yale Global Tic Severity Scale (YGTSS), 28 youth aged 6 to 17 years with Tourette's syndrome (TS) participated in the study. Data included clinician reports of tics and obsessive-compulsive disorder (OCD) severity, parent reports of tics, internalizing and externalizing problems, and child reports…

The effect of shoe toe box shape and volume on forefoot interdigital and plantar pressures in healthy females

PubMed Central

2013-01-01

Background Ill-fitting footwear can be detrimental to foot health with the forefoot being an area for most discomfort. Studies on footwear have primarily examined sports or orthopaedic prescription shoes and little is known about the effects that everyday flat shoes have on the forefoot. The aim of this study was to investigate the effect of toe box shape in a popular slip-on pump on dorsal and plantar pressures with particular interest around the forefoot in a healthy female population. Method A convenience sample of 27 female participants with no known foot pathologies was recruited. After assessment of foot size, plantar foot pressure and interdigital pressures were recorded for each of the 3 different toe box styles; round, square and pointed. Participants walked at a self-selected speed over a 10 m walkway whilst wearing each of the 3 styles of shoe and also whilst barefoot. Processed and analysed data extracted included peak pressure, time to peak pressure, contact time and pressure time integral. ANOVA and Freidman analysis was used to test for statistical significance. Results Shoes with a round toe showed least pressure around the medial aspect of the toes whilst the pointed shoe had least pressure on the lateral toes. Contact times for the plantar regions were not altered in any shoe condition yet contact around the medial aspect of the toes was highest in the pointed shoe. Conclusion This study highlights that the shape of the toe box in footwear can significantly influence the amount of pressure applied to the forefoot. Furthermore, the contours of the shoe also have an impact on the contact time and pressure time integral around the forefoot and also the peak plantar pressure in the toe region. The changes observed could be significant in the development of pathology in certain footwear toe box shapes. Consideration should be given to footwear design around the toe box to improve fit and reduce pressure. Further work is required to investigate the

Effects of Long-duration Space Flight on Toe Clearance During Treadmill Walking

NASA Technical Reports Server (NTRS)

Miller, Chris; Peters, Brian; Brady, Rachel; Mulavara, Ajitkumar; Richards, Jason; Hayat, Matthew; Bloomberg, Jacob

2008-01-01

Upon returning from long-duration space flight, astronauts and cosmonauts must overcome physiologic and sensorimotor changes induced by prolonged exposure to microgravity as they readapt to a gravitational environment. Their compromised balance and coordination lead to an altered and more variable walking pattern (Bloomberg & Mulavara, 2003; McDonald, et al., 1996). Toe trajectory during the swing phase of locomotion has been identified as a precise motor control task (Karst, et al., 1999), thus providing an indication of the coordination of the lower limbs (Winter, 1992). Failure to achieve sufficient toe clearance may put the crew member at a greater risk of tripping and falling, especially if an emergency egress from the vehicle should be necessary upon landing. The purpose of this study was to determine the pre- to post-flight changes in toe clearance in crew members returning from long-duration missions and the recovery thereafter.

Tourette Syndrome and Tic Disorders

PubMed Central

Leckman, James F.

2005-01-01

Objective: This is a practical review of Tourette syndrome, including phenomenology, natural history, and state-of-the-art assessment and treatment. Method: Computerized literature searches were conducted under the keywords Tourette syndrome,tics, and children-adolescents. Results: Studies have documented the natural history of Tourette syndrome and its frequent co-occurrence with attention problems, obsessive-compulsive disorder (OCD), and a range of other mood and anxiety disorders, which are often of primary concern to patients and their families. Proper diagnosis and education are often very helpful for patients, parents, siblings, teachers, and peers. When necessary, available anti-tic treatments have proven efficacious. First-line options include the alpha adrenergic agents and the atypical neuroleptics, as well as behavioral interventions such as habit reversal. Conclusions: The study of tics and Tourette symdrome has led to the development of several pathophysiological models and helped in the development of management options. However, fully explanatory models are still needed that would allow for accurate prognostication in the course of illness and the development of improved treatments. PMID:21152158

Prevalence of tics in schoolchildren in central Spain: a population-based study.

PubMed

Cubo, Esther; Gabriel y Galán, José María Trejo; Villaverde, Vanesa Ausín; Velasco, Sara Sáez; Benito, Vanesa Delgado; Macarrón, Jesús Vicente; Guevara, José Cordero; Louis, Elan D; Benito-León, Julián

2011-08-01

Tic disorders constitute a neurodevelopmental disorder of childhood. This study sought to determine the prevalence of tic disorders in a school-based sample. A randomized sample of 1158 schoolchildren, based on clusters (classrooms) in the province of Burgos (Spain), was identified on a stratified sampling frame combining types of educational center and setting (mainstream schools and special education), using a two-phase approach (screening and diagnosis ascertainment by a neurologist). Tics with/without impairment criterion were diagnosed according to Diagnostic and Statistical Manual of Mental Disorders criteria. In mainstream schools, tics were observed in 125/741 students (16.86%; 95% confidence interval, 14.10-19.63), and were more frequent in boys (87/448, 19.42%; 95% confidence interval, 15.64-23.19) compared with girls (38/293, 12.96%; 95% confidence interval, 8.95-16.98; P = 0.03). In special education centers, tics disorders were observed in 11/54 of children (20.37%; 95% confidence interval, 8.70-32.03). Overall, tics with impairment criteria were less frequent than tics without impairment criteria (4.65% vs 11.85%, P < 0.0001). The most frequent diagnoses involved chronic motor tics (6.07%) and Tourette syndrome (5.26%). Tic disorders are common in childhood, and the use or nonuse of impairment criteria exerts a significant impact on tic prevalence estimates. Copyright © 2011 Elsevier Inc. All rights reserved.

The effect of toe marker placement error on joint kinematics and muscle forces using OpenSim gait simulation.

PubMed

Xu, Hang; Merryweather, Andrew; Bloswick, Donald; Mao, Qi; Wang, Tong

2015-01-01

Marker placement can be a significant source of error in biomechanical studies of human movement. The toe marker placement error is amplified by footwear since the toe marker placement on the shoe only relies on an approximation of underlying anatomical landmarks. Three total knee replacement subjects were recruited and three self-speed gait trials per subject were collected. The height variation between toe and heel markers of four types of footwear was evaluated from the results of joint kinematics and muscle forces using OpenSim. The reference condition was considered as the same vertical height of toe and heel markers. The results showed that the residual variances for joint kinematics had an approximately linear relationship with toe marker placement error for lower limb joints. Ankle dorsiflexion/plantarflexion is most sensitive to toe marker placement error. The influence of toe marker placement error is generally larger for hip flexion/extension and rotation than hip abduction/adduction and knee flexion/extension. The muscle forces responded to the residual variance of joint kinematics to various degrees based on the muscle function for specific joint kinematics. This study demonstrates the importance of evaluating marker error for joint kinematics and muscle forces when explaining relative clinical gait analysis and treatment intervention.

Emplacement of Pahoehoe Toe Networks: Observations of May, 2010 Tube-fed Flows at Kilauea Volcano, Hawai'i

NASA Astrophysics Data System (ADS)

Crown, D. A.; Ramsey, M.; Hon, K.

2010-12-01

Pahoehoe lava flows are compound features that consist of multiple overlapping and interfingering lobes and exhibit morphologically diverse surfaces characterized by channelized zones, smooth-surfaced sheets, and numerous, small toe networks. Previous work compiled detailed planform maps of solidified pahoehoe toe networks to document their morphology, morphometry and connective relationships in order to provide constraints on lava transport models. In order to expand this research to active flow emplacement, we observed slow-moving, tube-fed pahoehoe flows on the coastal plain near Kalapana, Hawaii in May, 2010. The evolution of pahoehoe toe and toe network characteristics over their emplacement history was examined and the role of small-scale flow inflation on the advance of pahoehoe lobes evaluated. We collected both visible video footage and high-speed, high-precision thermal infrared (TIR) data using a FLIR S-40 camera. The TIR data provide surface temperature maps that can be easily used to identify formation of new toes and track their growth and surface cooling. From these maps, lobe development, connective relationships, and frontal and lateral spreading rates can be analyzed. Preliminary results suggest that regular cycles of activity characterize the development of these pahoehoe lobes: 1) emplacement of new toes in local topographic lows at the front, margin, and within the interior of an active lobe forming small interconnected networks, 2) decline and sometimes temporary cessation in the production of new pahoehoe toes, 3) inflation of the recently emplaced flow surface, either partially or en masse depending on the rate of influx of new lava, the degree of irregularity of the pre-flow surface, and/or the slope across the recently emplaced lava surface, and 4) fracturing of the recently emplaced surface crust that feeds emplacement of new toes. Inflation fractures typically cut across several previously emplaced toes and can occur at the front, along

Serum Ferritin Levels Are Lower in Children With Tic Disorders Compared with Children Without Tics: A Cross-Sectional Study.

PubMed

Avrahami, Matan; Barzilay, Ran; HarGil, Miki; Weizman, Abraham; Watemberg, Nathan

2017-03-01

Alteration in peripheral iron indices has been reported in a number of movement disorders, particularly Parkinson's disease. We hypothesized that iron stores may be diminished in children at an early stage of tic disorder. Using data retrieved from electronic medical records, we compared serum ferritin levels, an indicator of body iron store balance, in drug-naive children diagnosed for the first time with tic disorder (study group; N = 47, 32 boys/15 girls, aged 8.66 ± 3.17 years) compared to age- and sex-matched children with headaches (comparison group, n = 100, 62 boys/38 girls, aged 9.51 ± 3.15 years) treated in the same pediatric neurological clinic. Mean serum ferritin levels were significantly lower (-32%, p = 0.01) in the tic disorder group compared to the headache group. No significant differences were detected in circulatory hemoglobin, iron, transferrin, and platelet count between the two groups. Our findings suggest that body iron stores may be reduced in children with recent-onset tic disorder.

Plantar-Plate Disruptions: “The Severe Turf-Toe Injury.” Three Cases in Contact Athletes

PubMed Central

Drakos, Mark C.; Fiore, Russell; Murphy, Conor; DiGiovanni, Christopher W.

2015-01-01

Objective: To present 3 cases of plantar-plate rupture and turf-toe injury in contact athletes at 1 university and to discuss appropriate diagnosis and treatment algorithms for each case. Background: Turf toe is a common injury in athletes participating in outdoor cutting sports. However, it has been used as an umbrella term to describe many different injuries of the great toe. In some cases, the injury can be so severe that the plantar plate and sesamoid apparatus may be ruptured. These patients may be better managed with surgery than with traditional nonoperative interventions. Differential Diagnosis: Turf toe, plantar-plate disruption, sesamoid fracture. Treatment: For stable injuries in which the plantar plate is not completely disrupted, nonoperative treatment with casting or a stiff-soled shoe, gradual weight bearing, and rehabilitation is the best practice. Unstable injuries require surgical intervention and plantar-plate repair. Uniqueness: Turf toe and injury to the first metatarsophalangeal joint are relatively common injuries in athletes, but few researchers have detailed the operative and nonoperative treatments of plantar-plate disruption in these patients. We examine 3 cases that occurred over 4 seasons on a collegiate football team. Conclusions: Turf toe represents a wide array of pathologic conditions involving the first metatarsophalangeal joint. Stress and instability testing are key components to assess in determining whether surgical intervention is warranted to restore optimal function. Stiffer-soled shoes or shoes with steel-plate insertions may help to prevent these injuries and are useful tools for protection during the rehabilitation period. PMID:25695855

Preparation and properties of TiC-Ni cermets using Ni-plated TiC

NASA Astrophysics Data System (ADS)

Shin, Soon-Gi

2002-04-01

TiC powders were coated with Ni by a chemical plating technique and the pressed compacts sintered at 1623K. The density of the sintered bodies was 98-99%. Compared with mechanically-mixed powder, Ni-plated TiC powders gave a more uniform microstructure in which TiC particles were well dispersed in the Ni matrix. The cermets exhibited ductile fracture for TiC-70 vol.% Ni and brittle fracture for TiC-30 vol.% Ni. The flexural strength was improved by the homogeneous dispersion of TiC. The thermal expansion coefficient increased with a decrease in Ni content, following a nearly linear law of mixtures on the basis of volume fractions of pure TiC and Ni.

[Tourette syndrome and other tic disorders in DSM-5 – a comment].

PubMed

Roessner, Veit; Ludolph, Andrea G; Müller-Vahl, Kirsten; Neuner, Irene; Rothenberger, Aribert; Woitecki, Katrin; Münchau, Alexander

2014-03-01

The classification of tic disorders has been revised in the new fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The previously expressed suggestion to categorize tic disorders within the "Anxiety and Obsessive Compulsive Disorders" was not implemented. The section "Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence" was revised and renamed as "Neurodevelopmental Disorders." Tic disorders are classified there as movement disorders. Most of the changes are distinct improvements from both a clinical and a scientific perspective. For example, by removing the adjective "stereotype," the definition of tics is more precise and unified. Also, the new time-oriented criteria are more practical in the clinical setting, e.g., the exclusion criterion of a tic-free interval more than 3 months given for chronic tic disorders has been deleted. The renamings from "Transient" to "Provisional Tic Disorder" as well as from "Chronic" to "Persistent Tic Disorder" are welcome changes from a clinical perspective. Overall, the revision of the criteria is an important step towards providing more clarity and feasibility. However, the revised classification of tic disorders is still based only on clinical experience and not on evidence. Future studies should show whether the revised and improved criteria truly provide the optimal classification.

INTERMEDIATE STAGES OF REACTIONS FORMING CARBIDES OF TITANIUM, ZIRCONIUM, VANADIUM, NIOBIUM, AND TANTALIUM

DTIC Science & Technology

Tensimetric examination was made of the formation of the carbides TiC , ZrC, VC, NbC and TaC in a vacuum. During x-ray and chemical analysis of...for obtaining TiC , and ZrC through the stage of intermediate oxides Ti2O3, Ti3O5, TiO and Zr2O3, ZrO, respectively and also for the reaction of

Microsurgical transfer of the second toe for congenital deficiency of the thumb.

PubMed

Lister, G

1988-10-01

Twelve second-toe transfers have been performed to substitute for thumbs congenitally deficient through constriction ring syndrome, symbrachydactyly, and true transverse arrest. The children were on average 3 years of age, and the youngest was undertaken at 10 months. Anatomic variations were the rule in the six cases of transverse absence and the three cases of symbrachydactyly, requiring nerves, tendons, and vessels in the toe be connected to whatever appropriate structure could be located. All transfers survived, and only one required exploration. Sensation appeared good in the 11 seen in later review, but interphalangeal motion was achieved in only 3. However, good use was made of the digit by all except one patient, an early patient in whom there was not an adequate skeleton on which to base the transfer. This small series suggests that in appropriate cases toe transfer can be undertaken early for congenital deficiency with little fear of encountering microsurgical problems unique to the infant.

Botulinum toxin for motor and phonic tics in Tourette's syndrome.

PubMed

Pandey, Sanjay; Srivanitchapoom, Prachaya; Kirubakaran, Richard; Berman, Brian D

2018-01-05

Gilles de la Tourette syndrome, or Tourette's syndrome, is defined as the presence of both motor and vocal (phonic) tics for more than 12 months, that manifest before the age of 18 years, in the absence of secondary causes. Treatment of motor and phonic tics is difficult and challenging. To determine the safety and effectiveness of botulinum toxin in treating motor and phonic tics in people with Tourette's syndrome, and to analyse the effect of botulinum toxin on premonitory urge and sensory tics. We searched the Cochrane Movement Disorders Group Trials Register, CENTRAL, MEDLINE, and two trials registers to 25 October 2017. We reviewed reference lists of relevant articles for additional trials. We considered all randomised, controlled, double-blind studies comparing botulinum toxin to placebo or other medications for the treatment of motor and phonic tics in Tourette's syndrome for this review. We sought both parallel group and cross-over studies of children or adults, at any dose, and for any duration. We followed standard Cochrane methods to select studies, assess risk of bias, extract and analyse data. All authors independently abstracted data onto standardized forms; disagreements were resolved by mutual discussion. Only one randomised placebo-controlled, double-blind cross-over study met our selection criteria. In this study, 20 participants with motor tics were enrolled over a three-year recruitment period; 18 (14 of whom had a diagnosis of Tourette's syndrome) completed the study; in total, 21 focal motor tics were treated. Although we considered most bias domains to be at low risk of bias, the study recruited a small number of participants with relatively mild tics and provided limited data for our key outcomes. The effects of botulinum toxin injections on tic frequency, measured by videotape or rated subjectively, and on premonitory urge, are uncertain (very low-quality evidence). The quality of evidence for adverse events following botulinum toxin was

Further studies on lead compounds containing the opioid pharmacophore Dmt-Tic.

PubMed

Balboni, Gianfranco; Fiorini, Stella; Baldisserotto, Anna; Trapella, Claudio; Sasaki, Yusuke; Ambo, Akihiro; Marczak, Ewa D; Lazarus, Lawrence H; Salvadori, Severo

2008-08-28

Some reference opioids containing the Dmt-Tic pharmacophore, especially the delta agonists H-Dmt-Tic-Gly-NH-Ph (1) and H-Dmt-Tic-NH-(S)CH(CH2-COOH)-Bid (4) (UFP-512) were evaluated for the influence of the substitution of Gly with aspartic acid, its chirality, and the importance of the -NH-Ph and N(1)H-Bid hydrogens in the inductions of delta agonism. The results provide the following conclusions: (i) Asp increases delta selectivity by lowering the mu affinity; (ii) -NH-Ph and N(1)H-Bid nitrogens methylation transforms the delta agonists into delta antagonists; (iii) the substitution of Gly with L-Asp/D-Asp in the delta agonist H-Dmt-Tic-Gly-NH-Ph gave delta antagonists; the same substitution in the delta agonist H-Dmt-Tic-NH-CH2-Bid yielded more selective agonists, H-Dmt-Tic-NH-(S)CH(CH2-COOH)-Bid and H-Dmt-Tic-NH-(R)CH(CH2-COOH)-Bid; (iv) L-Asp seems important only in functional bioactivity, not in receptor affinity; (v) H-Dmt-Tic-NH-(S)CH(CH2-COOH)-Bid(N(1)-Me) (10) evidenced analgesia similar to 4, which was reversed by naltrindole only in the tail flick. 4 and 10 had opposite behaviours in mice; 4 caused agitation, 10 gave sedation and convulsions.

Prefrontal cortex volume reductions and tic inhibition are unrelated in uncomplicated GTS adults.

PubMed

Ganos, Christos; Kühn, Simone; Kahl, Ursula; Schunke, Odette; Brandt, Valerie; Bäumer, Tobias; Thomalla, Götz; Haggard, Patrick; Münchau, Alexander

2014-01-01

Tics in Gilles de la Tourette syndrome (GTS) are repetitive patterned movements, resembling spontaneous motor behaviour, but escaping voluntary control. Previous studies hypothesised relations between structural alterations in prefrontal cortex of GTS adults and tic severity using voxel-based morphometry (VBM), but could not demonstrate a significant association. The relation between prefrontal cortex structure and tic inhibition has not been investigated. Here, we used VBM to examine 14 GTS adults without associated comorbidities, and 15 healthy controls. We related structural alterations in GTS to clinical measures of tic severity and tic control. Grey matter volumes in the right inferior frontal gyrus and the left frontal pole were reduced in patients relative to healthy controls. These changes were not related to tic severity and tic inhibition. Prefrontal grey matter volume reductions in GTS adults are not related to state measures of tic phenomenology. © 2013.

[Double toe to hand transfer in children with symbrachydactyly].

PubMed

Rivas, S; López-Gutiérrez, J C; Lovic, A; Díaz, M; Andrés, A M; Ros, Z

2006-07-01

Symbrachydactyly is fairly frequent congenital malformation that appears during first weeks of pregnancy. The range of clinical presentations goes from hypoplastic fingers to true agenesis. Although it usually appears in a random fashion, sometimes it is associated to other systemic malformations. The aim of this study is to check the functional, cosmetic and psychological results of those patients affected of grade IV symbrachydactyly treated using a double second toe transfer. The method employed is a retrospective study of the clinical records from 6 patients (5 males and 1 female) operated in our Department during the last five years. The follow up period was from 3 months to five years. Transfer from the second toe to the first ray was performed during the first surgical period, while transfer to the fourth ray was done in a second procedure. The mean age for the first operation was 19 months, and 30 months for the second one. There were no flap failure or major surgical complications. Tenolysis and tenoplasty was done in two patients to improve flap function and position. Motion rehabilitation was installed during the postoperative period. Functional, opposing pinch, and cosmetic results were satisfactory. Parents "and patients" psychological acceptance was also good. No walk disturbance was observed. Double second toe to hand transfer is a good option for the symbrachydactyly treatment in cases of thumb agenesis. Rehabilitation is the key clue for functional recovery. Surgery improves social and family relationships.

The Neuropeptide Tac2 Controls a Distributed Brain State Induced by Chronic Social Isolation Stress.

PubMed

Zelikowsky, Moriel; Hui, May; Karigo, Tomomi; Choe, Andrea; Yang, Bin; Blanco, Mario R; Beadle, Keith; Gradinaru, Viviana; Deverman, Benjamin E; Anderson, David J

2018-05-17

Chronic social isolation causes severe psychological effects in humans, but their neural bases remain poorly understood. 2 weeks (but not 24 hr) of social isolation stress (SIS) caused multiple behavioral changes in mice and induced brain-wide upregulation of the neuropeptide tachykinin 2 (Tac2)/neurokinin B (NkB). Systemic administration of an Nk3R antagonist prevented virtually all of the behavioral effects of chronic SIS. Conversely, enhancing NkB expression and release phenocopied SIS in group-housed mice, promoting aggression and converting stimulus-locked defensive behaviors to persistent responses. Multiplexed analysis of Tac2/NkB function in multiple brain areas revealed dissociable, region-specific requirements for both the peptide and its receptor in different SIS-induced behavioral changes. Thus, Tac2 coordinates a pleiotropic brain state caused by SIS via a distributed mode of action. These data reveal the profound effects of prolonged social isolation on brain chemistry and function and suggest potential new therapeutic applications for Nk3R antagonists. Copyright © 2018 Elsevier Inc. All rights reserved.

Effect of Guci powder on toe swelling induced by egg white in rats

NASA Astrophysics Data System (ADS)

Xie, Guoqi; Hao, Shaojun; Shen, Huiling; Ma, Zhenzhen; Zhang, Xuehui; Zhang, Zhengchen

2018-04-01

To observe the effect of Guci Powder on foot swelling induced by egg white in rats. 50 male rats were randomly divided into normal saline group (n=10), white vinegar group (n=10) and Guning lotion group (n=10). There were 10 rats in the high-dose group and 10 in the low-dose group. The rats in each group were treated with the drug on the left and right feet of the rats. 0.5 hours after the last administration, the rats in each group were inflamed. The left hindsole plantar volume was measured respectively, so that the difference of the posterior toe volume before inflammation was taken as the swelling degree, and the swelling degree of each group was calculated. Compared with physiological saline group, the rats' egg white toe swelling (P<0.01) was significantly inhibited at 0.5˜6h after administration. The swelling of egg white toe in rats was inhibited at 0.5˜2h (P<0.05). Bone spur powder has a good intervention effect on the model of toe swelling induced by egg white in rats, and the external application of bone spur powder has anti-inflammatory and swelling effect.

Effect of lysine at C-terminus of the Dmt-Tic opioid pharmacophore.

PubMed

Balboni, Gianfranco; Onnis, Valentina; Congiu, Cenzo; Zotti, Margherita; Sasaki, Yusuke; Ambo, Akihiro; Bryant, Sharon D; Jinsmaa, Yunden; Lazarus, Lawrence H; Trapella, Claudio; Salvadori, Severo

2006-09-07

Substitution of Gly with side-chain-protected or unprotected Lys in lead compounds containing the opioid pharmacophore Dmt-Tic [H-Dmt-Tic-Gly-NH-CH(2)-Ph, mu agonist/delta antagonist; H-Dmt-Tic-Gly-NH-Ph, mu agonist/delta agonist; and H-Dmt-Tic-NH-CH(2)-Bid, delta agonist (Bid = 1H-benzimidazole-2-yl)] yielded a new series of compounds endowed with distinct pharmacological activities. Compounds (1-10) included high delta- (Ki(delta) = 0.068-0.64 nM) and mu-opioid affinities (Ki(mu) = 0.13-5.50 nM), with a bioactivity that ranged from mu-opioid agonism {10, H-Dmt-Tic-NH-CH[(CH2)4-NH2]-Bid (IC50 GPI = 39.7 nM)} to a selective mu-opioid antagonist [3, H-Dmt-Tic-Lys-NH-CH2-Ph (pA2(mu) = 7.96)] and a selective delta-opioid antagonist [5, H-Dmt-Tic-Lys(Ac)-NH-Ph (pA2(delta) = 12.0)]. The presence of a Lys linker provides new lead compounds in the formation of opioid peptidomimetics containing the Dmt-Tic pharmacophore with distinct agonist and/or antagonist properties.

Tic Symptoms Induced by Atomoxetine in Treatment of ADHD: A Case Report and Literature Review.

PubMed

Yang, Rongwang; Li, Rong; Gao, Weijia; Zhao, Zhengyan

Patients with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for tic disorders. Atomoxetine (ATX) has been accepted as an alternative medication for patients with ADHD and a comorbid tic disorder. It is rarely reported that tic symptoms are induced by ATX. This present report described a boy with ADHD who developed tic symptoms during ATX initiation. We used an ABAB trial to confirm the tics were related to ATX administration. In addition, we reviewed the published literature of patients whose tic symptoms were confirmed or suspected of relating to ATX usage. This present case with an ABAB design showed on-off control of tics with or without ATX, which allowed us to make a strong conclusion that the tics were related to ATX administration. Literature review also indicated that ATX might induce tic symptoms in children with ADHD, especially in those being boys and having a history of tics. The time from starting ATX to tics symptoms appearing was approximately 19 days. The most common tic symptoms were eye blinking, vocal tics, or throat clearing, and neck movements. These tics symptoms in most cases could be resolved after discontinuing ATX without further pharmacotherapy. Pediatricians and child psychiatrists should be well aware of this potential adverse effect in children with ADHD receiving ATX.

Nanodiamond embedded ta-C composite film by pulsed filtered vacuum arc deposition from a single target

NASA Astrophysics Data System (ADS)

Iyer, Ajai; Etula, Jarkko; Ge, Yanling; Liu, Xuwen; Koskinen, Jari

2016-11-01

Detonation Nanodiamonds (DNDs) are known to have sp3 core, sp2 shell, small size (few nm) and are gaining importance as multi-functional nanoparticles. Diverse methods have been used to form composites, containing detonation nanodiamonds (DNDs) embedded in conductive and dielectric matrices for various applications. Here we show a method, wherein DND-ta-C composite film, consisting of DNDs embedded in ta-C matrix have been co-deposited from the same cathode by pulsed filtered cathodic vacuum arc method. Transmission Electron Microscope analysis of these films revel the presence of DNDs embedded in the matrix of amorphous carbon. Raman spectroscopy indicates that the presence of DNDs does not adversely affect the sp3 content of DND-ta-C composite film compared to ta-C film of same thickness. Nanoindentation and nanowear tests indicate that DND-ta-C composite films possess improved mechanical properties in comparison to ta-C films of similar thickness.

Fire service and first responder thermal imaging camera (TIC) advances and standards

NASA Astrophysics Data System (ADS)

Konsin, Lawrence S.; Nixdorff, Stuart

2007-04-01

Fire Service and First Responder Thermal Imaging Camera (TIC) applications are growing, saving lives and preventing injury and property damage. Firefighters face a wide range of serious hazards. TICs help mitigate the risks by protecting Firefighters and preventing injury, while reducing time spent fighting the fire and resources needed to do so. Most fire safety equipment is covered by performance standards. Fire TICs, however, are not covered by such standards and are also subject to inadequate operational performance and insufficient user training. Meanwhile, advancements in Fire TICs and lower costs are driving product demand. The need for a Fire TIC Standard was spurred in late 2004 through a Government sponsored Workshop where experts from the First Responder community, component manufacturers, firefighter training, and those doing research on TICs discussed strategies, technologies, procedures, best practices and R&D that could improve Fire TICs. The workshop identified pressing image quality, performance metrics, and standards issues. Durability and ruggedness metrics and standard testing methods were also seen as important, as was TIC training and certification of end-users. A progress report on several efforts in these areas and their impact on the IR sensor industry will be given. This paper is a follow up to the SPIE Orlando 2004 paper on Fire TIC usage (entitled Emergency Responders' Critical Infrared) which explored the technological development of this IR industry segment from the viewpoint of the end user, in light of the studies and reports that had established TICs as a mission critical tool for firefighters.

Provisional Tic Disorder: What to tell parents when their child first starts ticcing.

PubMed

Black, Kevin J; Black, Elizabeth Rose; Greene, Deanna J; Schlaggar, Bradley L

2016-01-01

The child with recent onset of tics is a common patient in a pediatrics or child neurology practice. If the child's first tic was less than a year in the past, the diagnosis is usually Provisional Tic Disorder (PTD). Published reviews by experts reveal substantial consensus on prognosis in this situation: the tics will almost always disappear in a few months, having remained mild while they lasted. Surprisingly, however, the sparse existing data may not support these opinions. PTD may have just as much importance for science as for clinical care. It provides an opportunity to prospectively observe the spontaneous remission of tics. Such prospective studies may aid identification of genes or biomarkers specifically associated with remission rather than onset of tics. A better understanding of tic remission may also suggest novel treatment strategies for Tourette syndrome, or may lead to secondary prevention of tic disorders. This review summarizes the limited existing data on the epidemiology, phenomenology, and outcome of PTD, highlights areas in which prospective study is sorely needed, and proposes that tic disorders may completely remit much less often than is generally believed.

Provisional Tic Disorder: What to tell parents when their child first starts ticcing

PubMed Central

Black, Kevin J; Black, Elizabeth Rose; Greene, Deanna J.; Schlaggar, Bradley L.

2016-01-01

The child with recent onset of tics is a common patient in a pediatrics or child neurology practice. If the child’s first tic was less than a year in the past, the diagnosis is usually Provisional Tic Disorder (PTD). Published reviews by experts reveal substantial consensus on prognosis in this situation: the tics will almost always disappear in a few months, having remained mild while they lasted. Surprisingly, however, the sparse existing data may not support these opinions. PTD may have just as much importance for science as for clinical care. It provides an opportunity to prospectively observe the spontaneous remission of tics. Such prospective studies may aid identification of genes or biomarkers specifically associated with remission rather than onset of tics. A better understanding of tic remission may also suggest novel treatment strategies for Tourette syndrome, or may lead to secondary prevention of tic disorders. This review summarizes the limited existing data on the epidemiology, phenomenology, and outcome of PTD, highlights areas in which prospective study is sorely needed, and proposes that tic disorders may completely remit much less often than is generally believed. PMID:27158458

Social disinhibition is a heritable subphenotype of tics in Tourette syndrome

PubMed Central

Hirschtritt, Matthew E.; Darrow, Sabrina M.; Illmann, Cornelia; Osiecki, Lisa; Grados, Marco; Sandor, Paul; Dion, Yves; King, Robert A.; Pauls, David L.; Budman, Cathy L.; Cath, Danielle C.; Greenberg, Erica; Lyon, Gholson J.; Yu, Dongmei; McGrath, Lauren M.; McMahon, William M.; Lee, Paul C.; Delucchi, Kevin L.; Scharf, Jeremiah M.

2016-01-01

Objective: To identify heritable symptom-based subtypes of Tourette syndrome (TS). Methods: Forty-nine motor and phonic tics were examined in 3,494 individuals (1,191 TS probands and 2,303 first-degree relatives). Item-level exploratory factor and latent class analyses (LCA) were used to identify tic-based subtypes. Heritabilities of the subtypes were estimated, and associations with clinical characteristics were examined. Results: A 6-factor exploratory factor analysis model provided the best fit, which paralleled the somatotopic representation of the basal ganglia, distinguished simple from complex tics, and separated out socially disinhibited and compulsive tics. The 5-class LCA model best distinguished among the following groups: unaffected, simple tics, intermediate tics without social disinhibition, intermediate with social disinhibition, and high rates of all tic types. Across models, a phenotype characterized by high rates of social disinhibition emerged. This phenotype was associated with increased odds of comorbid psychiatric disorders, in particular, obsessive-compulsive disorder and attention-deficit/hyperactivity disorder, earlier age at TS onset, and increased tic severity. The heritability estimate for this phenotype based on the LCA was 0.53 (SE 0.08, p 1.7 × 10−18). Conclusions: Expanding on previous modeling approaches, a series of TS-related phenotypes, including one characterized by high rates of social disinhibition, were identified. These phenotypes were highly heritable and may reflect underlying biological networks more accurately than traditional diagnoses, thus potentially aiding future genetic, imaging, and treatment studies. PMID:27371487

Social disinhibition is a heritable subphenotype of tics in Tourette syndrome.

PubMed

Hirschtritt, Matthew E; Darrow, Sabrina M; Illmann, Cornelia; Osiecki, Lisa; Grados, Marco; Sandor, Paul; Dion, Yves; King, Robert A; Pauls, David L; Budman, Cathy L; Cath, Danielle C; Greenberg, Erica; Lyon, Gholson J; Yu, Dongmei; McGrath, Lauren M; McMahon, William M; Lee, Paul C; Delucchi, Kevin L; Scharf, Jeremiah M; Mathews, Carol A

2016-08-02

To identify heritable symptom-based subtypes of Tourette syndrome (TS). Forty-nine motor and phonic tics were examined in 3,494 individuals (1,191 TS probands and 2,303 first-degree relatives). Item-level exploratory factor and latent class analyses (LCA) were used to identify tic-based subtypes. Heritabilities of the subtypes were estimated, and associations with clinical characteristics were examined. A 6-factor exploratory factor analysis model provided the best fit, which paralleled the somatotopic representation of the basal ganglia, distinguished simple from complex tics, and separated out socially disinhibited and compulsive tics. The 5-class LCA model best distinguished among the following groups: unaffected, simple tics, intermediate tics without social disinhibition, intermediate with social disinhibition, and high rates of all tic types. Across models, a phenotype characterized by high rates of social disinhibition emerged. This phenotype was associated with increased odds of comorbid psychiatric disorders, in particular, obsessive-compulsive disorder and attention-deficit/hyperactivity disorder, earlier age at TS onset, and increased tic severity. The heritability estimate for this phenotype based on the LCA was 0.53 (SE 0.08, p 1.7 × 10(-18)). Expanding on previous modeling approaches, a series of TS-related phenotypes, including one characterized by high rates of social disinhibition, were identified. These phenotypes were highly heritable and may reflect underlying biological networks more accurately than traditional diagnoses, thus potentially aiding future genetic, imaging, and treatment studies. © 2016 American Academy of Neurology.

Tourette syndrome and other tic disorders in childhood, adolescence and adulthood.

PubMed

Ludolph, Andrea G; Roessner, Veit; Münchau, Alexander; Müller-Vahl, Kirsten

2012-11-01

Tourette syndrome is a combined motor and vocal tic disorder that begins in childhood and takes a chronic course. It arises in about 1% of all children, with highly varying severity. Transient and usually mild tics are seen in as many as 15% of all children in elementary school. The diagnosis is often delayed by several years. We selectively reviewed the pertinent literature, including the guidelines of the European Society for the Study of Tourette Syndrome for the diagnosis and treatment of tic disorders. Tic disorders usually take a benign course, with spontaneous improvement in adolescence in about 90% of patients. Psychoeducation is the basis of treatment in each case and almost always brings marked emotional relief. Specific treatment is needed only for more severe tics and those that cause evident psychosocial impairment. 80-90% of patients with Tourette syndrome have comorbidities (attention deficit-hyperactivity disorder, obsessive-compulsive disorder, depression, anxiety, emotional dysregulation, autoaggression), which often impair their quality of life more than the tics do and therefore become the main target of treatment. There is little evidence for the efficacy of treatment for tics. Small-scale controlled studies with a brief follow-up period have been carried out for some neuroleptic drugs. Behavior therapy should be tried before drug treatment. A further option for very severely affected adults is deep brain stimulation. Because of the low level of the available evidence, no definitive recommendations can be made for the treatment of tics.

Lower-extremity rotational profile and toe-walking in preschool children with autism spectrum disorder.

PubMed

Arik, Atilla; Aksoy, Cemalettin; Aysev, Ayla; Akçakin, Melda

2018-04-24

The aim of this study was to establish the torsional and toe-walking profiles of children with autism spectrum disorder (ASD), and to analyze the correlations between torsion, toe-walking, autism severity score, and age. In total, 79 consecutive children with autism were examined to determine their hip rotations, thigh-foot angle, degree of toe-walking, and autism severity. Femoral and tibial torsion values, of the preschool patients, were compared statistically with age-matched controls. The hip rotation profile of the patients was similar to the normal group. Nearly a half of the patients with ASD present excessive external tibial torsion. The difference in the tibial torsion between patients and normal children was statistically significant. A weak correlation was found only between tibial torsion and the autism severity score, but no correlation was found between the other parameters. External tibial torsion is the cardinal and persistent orthopedic manifestation among patients with ASD. Toe-walking is the second most common such manifestation and is an independent orthopedic feature in these patients. External tibial torsion may potentially contribute toward the described gait abnormalities in patients with ASD.

Tic Disorders and Learning Disability: Clinical Characteristics, Cognitive Performance and Comorbidity

ERIC Educational Resources Information Center

Eapen, Valsamma; Crncec, Rudi; McPherson, Sarah; Snedden, Corina

2013-01-01

Tics are involuntary movements or sounds. Tourette syndrome is one of a family of tic disorders that affect around 1% of the population but which remains underrecognised in the community. In paediatric special education learning disability classes, the prevalence of individuals with tic disorders is around 20-45%--higher still in special education…

Tic douloureux.

PubMed

Sweeney, P J

1981-02-01

Tic douloureux (trigerminal neuralgia) usually has its onset in the sixth or seventh decade and is characterized by severe, excruciating facial pain which is almost always unilateral. The mandibular division and the maxillary division of the fifth cranial nerve are most commonly affected. Carbamazepine is the drug of choice. Currently popular surgical procedures include decompression of the fifth cranial nerve and percutaneous thermal lesioning of the gasserian ganglion.

Tics and Tourette Syndrome in Autism Spectrum Disorders

ERIC Educational Resources Information Center

Canitano, Roberto; Vivanti, Giacomo

2007-01-01

Autism spectrum disorders (ASDs) are more frequently associated with tic disorders than expected by chance. Variable rates of comorbidity have been reported and common genetic and neurobiological factors are probably involved. The aim of this study was to determine the rate of tic disorders in a clinical sample (n = 105) of children and…

Pimozide for tics in Tourette's syndrome.

PubMed

Pringsheim, Tamara; Marras, Connie

2009-04-15

Neuroleptic drugs with potent D-2 receptor blocking properties have been the traditional treatment for tics caused by Tourette Syndrome. Pimozide is the most studied of these. Use of these medications is declining because of concerns about side effects, and new atypical neuroleptics are now available. The true benefit and risks associated with pimozide compared to other drugs is not known. To evaluate the efficacy and harms of pimozide in comparison to placebo or other medications in the treatment of tics in Tourette Syndrome. We cross-referenced pimozide and its proprietary names with Tourette Syndrome and its derivations, as MeSH headings and as text words, and searched the Cochrane Movement Disorders Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 4), MEDLINE (1950-April 2007), and EMBASE (1980-April 2007). Reference lists of relevant articles were reviewed for additional trials. All randomized, controlled, double blind studies comparing pimozide to placebo or other medications for the treatment of tics in Tourette Syndrome were considered for inclusion in this review. Both parallel group and crossover studies of children or adults, at any dose and for any duration, were included. Data was abstracted independently by two authors onto standardized forms and disagreements were resolved by discussion. Six randomized controlled trials were included (total 162 participants, age range 7 to 53 years). Pimozide was compared with: placebo and haloperidol (two trials), placebo (one trial), haloperidol (one trial), and risperidone (two trials). Methodological quality was rated 'fair' for all studies. Studies used different outcome measurement scales for assessing tic severity and adverse effects. Significant clinical heterogeneity made meta-analysis inappropriate. Pimozide was superior to placebo in three studies, though it caused more side effects than placebo in one of these. Pimozide was inferior to

Pediatric obsessive-compulsive disorder with tic symptoms: clinical presentation and treatment outcome.

PubMed

Højgaard, Davíð R M A; Skarphedinsson, Gudmundur; Nissen, Judith Becker; Hybel, Katja A; Ivarsson, Tord; Thomsen, Per Hove

2017-06-01

Some studies have shown that children and adolescents with obsessive-compulsive disorder (OCD) and co-morbid tics differ from those without co-morbid tics in terms of several demographic and clinical characteristics. However, not all studies have confirmed these differences. This study examined children and adolescents with OCD and with possible or definite tic specifiers according to the DSM-5 in order to see whether they differ from patients without any tic symptoms regarding clinical presentation and outcome of cognitive behavioral therapy (CBT). The full sample included 269 patients (aged 7-17) with primary DSM-IV OCD who had participated in the Nordic Long-term Treatment Study (NordLOTS). Symptoms of tics were assessed using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL). One or more tic symptoms were found in 29.9% of participants. Those with OCD and co-morbid tic symptoms were more likely male, more likely to have onset of OCD at an earlier age, and differed in terms of OCD symptom presentation. More specifically, such participants also showed more symptoms of OCD-related impairment, externalization, autism spectrum disorder (ASD), social anxiety, and attention-deficit/hyperactivity disorder (ADHD). However, the two groups showed no difference in terms of OCD severity or outcome of CBT. Children and adolescents with OCD and co-morbid tic symptoms differ from those without tic symptoms in several aspects of clinical presentation, but not in their response to CBT. Our results underscore the effectiveness of CBT for tic-related OCD. Nordic Long-term Obsessive-Compulsive Disorder (OCD) Treatment Study; www.controlled-trials.com ; ISRCTN66385119.

Baseline Field Testing of BB-2590 Lithium-Ion Batteries using an iRobot FasTac 510 Robot

DTIC Science & Technology

2010-09-17

No. 21320 Baseline Field Testing of BB-2590 Lithium - Ion Batteries using an iRobot FasTac 510 Robot U.S. Army Tank...SEP 2010 2. REPORT TYPE N/A 3. DATES COVERED - 4. TITLE AND SUBTITLE Baseline Field Testing of BB-2590 Lithium - Ion Batteries using an iRobot...COVERED (From - To) Baseline Field Testing of BB-2590 Lithium - Ion Batteries using an 4. TITLE AND SUBTITLE iRobot FasTac 510 Robot 5a. CONTRACT

VISIT-TS: A multimedia tool for population studies on tic disorders.

PubMed

Vachon, M Jonathan; Striley, Catherine W; Gordon, Mollie R; Schroeder, Miriam L; Bihun, Emily C; Koller, Jonathan M; Black, Kevin J

2016-01-01

Population-based assessment of Tourette syndrome (TS) and other tic disorders produces a paradox. On one hand, ideally diagnosis of tic disorders requires expert observation. In fact, diagnostic criteria for TS explicitly require expert assessment of tics for a definite diagnosis. On the other hand, large-scale population surveys with expert assessment of every subject are impracticable. True, several published studies have successfully used expert assessment to find tic prevalence in a representative population (e.g. all students in a school district). However, extending these studies to larger populations is daunting. We created a multimedia tool to demonstrate tics to a lay audience, discuss their defining and common attributes, and address features that differentiate tics from other movements and vocalizations. A first version was modified to improve clarity and to include a more diverse group in terms of age and ethnicity. The result is a tool intended for epidemiological research. It may also provide additional benefits, such as more representative minority recruitment for other TS studies and increased community awareness of TS.

TAC1 Gene Products Regulate Pituitary Hormone Secretion and Gene Expression in Prepubertal Grass Carp Pituitary Cells.

PubMed

Hu, Guangfu; He, Mulan; Ko, Wendy K W; Wong, Anderson O L

2017-06-01

Tachykinin-1 (TAC1) is known to have diverse functions in mammals, but similar information is scarce in fish species. Using grass carp as a model, the pituitary actions, receptor specificity and postreceptor signaling of TAC1 gene products, namely substance P (SP) and neurokinin A (NKA), were examined. TAC1 encoding SP and NKA as well as tachykinin receptors NK1R and NK2R were cloned in the carp pituitary. The newly cloned receptors were shown to be functional with properties similar to mammalian counterparts. In carp pituitary cells, SP and NKA could trigger luteinizing hormone (LH), prolactin (PRL), and somatolactin α (SLα) secretion, with parallel rises in PRL and SLα transcripts. Short-term SP treatment (3 hours) induced LH release, whereas prolonged induction (24 hours) could attenuate LHβ messenger RNA (mRNA) expression. At pituitary cell level, LH, PRL, and SLα regulation by TAC1 gene products were mediated by NK1R, NK2R, and NK3R, respectively. Apparently, SP- and NKA-induced LH and SLα secretion and transcript expression were mediated by adenylyl cyclase/cyclic adenosine monophosphate (cAMP)/protein kinase A (PKA), phospholiphase C (PLC)/inositol 1,4,5-triphosphate/protein kinase C (PKC), and Ca2+/calmodulin (CaM)/CaM-dependent protein kinase-II pathways. The signal transduction for PRL responses was similar, except for the absence of a PKC component. Regarding SP inhibition of LHβ mRNA expression, the cAMP/PKA- and PLC/PKC-dependent (but not Ca2+/CaM-dependent) cascades were involved. These results, as a whole, suggest that TAC1 gene products play a role in LH, PRL, and SLα regulation via overlapping postreceptor signaling coupled to different subtypes of tachykinin receptor expressed in the carp pituitary. Copyright © 2017 Endocrine Society.

16 CFR Figures 6 and 7 to Part 1512 - Toe Clearance and Chain Guard Requirements

Code of Federal Regulations, 2011 CFR

2011-01-01

... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Toe Clearance and Chain Guard Requirements 6 Figures 6 and 7 to Part 1512 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT REGULATIONS REQUIREMENTS FOR BICYCLES Pt. 1512, Figs. 6 and 7 Figures 6 and 7 to Part 1512—Toe...

16 CFR Figures 6 and 7 to Part 1512 - Toe Clearance and Chain Guard Requirements

Code of Federal Regulations, 2010 CFR

2010-01-01

... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Toe Clearance and Chain Guard Requirements 6 Figures 6 and 7 to Part 1512 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT REGULATIONS REQUIREMENTS FOR BICYCLES Pt. 1512, Figs. 6 and 7 Figures 6 and 7 to Part 1512—Toe...

Non-vascularized free toe phalanx transfers in congenital hand deformities--the Great Ormond Street experience.

PubMed

Cavallo, A V; Smith, P J; Morley, S; Morsi, A W

2003-12-01

Many options of varying complexity are available for the management of congenital short digits resulting from aphalangia in symbrachydactyly and constriction ring syndrome. We have used non-vascularized free toe phalanx transfers for these children when a vascularized toe transfer has been contraindicated. We describe our technique and experience with 22 children who underwent a total of 64 transfers of the proximal (35) or middle (29) toe phalanges (average 3 per child). The mean age at initial surgery was 15 months, and the mean follow-up was 5 years. Duration of time until epiphyseal closure could not be determined accurately, but total digital elongation averaged 6mm. Complications of this technique include joint instability, premature epiphyseal closure and, in one patient, infection and graft loss. Donor site deformity was determined according to measured growth deficit and toe function. This technique is a simple option for digital elongation and, if performed in the appropriate age group in short fingered and monodactylous subtypes of symbrachydactyly, has the potential to allow growth and function with minimal donor site deficit.

Adhesion and friction in gecko toe attachment and detachment

PubMed Central

Tian, Yu; Pesika, Noshir; Zeng, Hongbo; Rosenberg, Kenny; Zhao, Boxin; McGuiggan, Patricia; Autumn, Kellar; Israelachvili, Jacob

2006-01-01

Geckos can run rapidly on walls and ceilings, requiring high friction forces (on walls) and adhesion forces (on ceilings), with typical step intervals of ≈20 ms. The rapid switching between gecko foot attachment and detachment is analyzed theoretically based on a tape model that incorporates the adhesion and friction forces originating from the van der Waals forces between the submicron-sized spatulae and the substrate, which are controlled by the (macroscopic) actions of the gecko toes. The pulling force of a spatula along its shaft with an angle θ between 0 and 90° to the substrate, has a “normal adhesion force” contribution, produced at the spatula-substrate bifurcation zone, and a “lateral friction force” contribution from the part of spatula still in contact with the substrate. High net friction and adhesion forces on the whole gecko are obtained by rolling down and gripping the toes inward to realize small pulling angles θ between the large number of spatulae in contact with the substrate. To detach, the high adhesion/friction is rapidly reduced to a very low value by rolling the toes upward and backward, which, mediated by the lever function of the setal shaft, peels the spatulae off perpendicularly from the substrates. By these mechanisms, both the adhesion and friction forces of geckos can be changed over three orders of magnitude, allowing for the swift attachment and detachment during gecko motion. The results have obvious implications for the fabrication of dry adhesives and robotic systems inspired by the gecko's locomotion mechanism. PMID:17148600

LncMAPK6 drives MAPK6 expression and liver TIC self-renewal.

PubMed

Huang, Guanqun; Jiang, Hui; He, Yueming; Lin, Ye; Xia, Wuzheng; Luo, Yuanwei; Liang, Min; Shi, Boyun; Zhou, Xinke; Jian, Zhixiang

2018-05-15

Liver tumor initiating cells (TICs) have self-renewal and differentiate capacities, and largely contribute to tumor initiation, metastasis and drug resistance. MAPK signaling is a critical pathway in many biological processes, while its role in liver TICs hasn't been explored. Online-available dataset was used for unbiased screening. Liver TICs were examined CD133 FACS or oncosphere formation. TIC self-renewal was detected by oncosphere formation and tumor initiation assay. LncRNA function was detected by loss of function or gain of function assays. The molecular mechanism of lncRNA was explored by RNA pulldown, RNA immunoprecipitation, ChIP, western blot and double FISH. Here, we examined the expression profiles of MAPK components (MAPKs, MAP2Ks, MAP3Ks, MAP4Ks), and found MAPK6 is most highly expressed in liver cancer samples. Moreover, a divergent lncRNA (long noncoding RNA) of MAPK6, termed lncMAPK6 here, is also overexpressed along with liver tumorigenesis. LncMAPK6 promotes liver tumor propagation and TIC self-renewal through MAPK6. LncMAPK6 interacts with and recruits RNA polymerase II to MAPK6 promoter, and finally activates the transcription of MAPK6. Through MAPK6 transcriptional regulation, lncMAPK6 drives MARK signaling activation. LncMAPK6-MAPK6 pathway can be used for liver TIC targeting. Altogether, lncMAPK6 promotes MARK signaling and the self-renewal of liver TICs through MAPK6 expression. MAPK6 was the most highly expressed MAPK component in liver cancer and liver TICs and lncMAPK6 participated in the transcriptional regulation of MAPK6in cis. This work revealed the importance role of MAPK signaling in liver TIC self-renewal and added a new layer for liver TIC and MAPK6 expression regulation.

Lamotrigine Induced Whole Body Tics: A Case Report and Literature Review.

PubMed

Centorino, Michael B; Catalano, Glenn; Catalano, Maria C

2016-01-01

Lamotrigine is an anticonvulsant medication that also has utility in the treatment of bipolar disorder. It has been associated with many side effects, including rashes that can progress to Stevens-Johnson syndrome or toxic epidermal necrolysis. It has also been associated with the development of motor tics, most commonly in the head, neck, and shoulders. We will now present the case of a 45-year-old woman who developed tics that involved the entire left side of her body after her dose of lamotrigine was increased from 200 mg daily (2.0 mg/kg/day) to 225 mg daily (2.3 mg/kg/day). We will review the prior cases of lamotrigine induced tics, and compare them to the circumstances surrounding our patient. We will also discuss the neurobiology of tics and make suggestions to improve the tics, based on the reported cases.

An initial study of family accommodation in children and adolescents with chronic tic disorders.

PubMed

Storch, Eric A; Johnco, Carly; McGuire, Joseph F; Wu, Monica S; McBride, Nicole M; Lewin, Adam B; Murphy, Tanya K

2017-01-01

This initial study examined the nature, incidence, and clinical correlates of family accommodation in youth with tic disorders, and validated a brief self-report measure of tic-related family accommodation, the Tic Family Accommodation Scale (TFAS). Seventy-five youth aged 6-18 who were diagnosed with a tic disorder and their parent completed a diagnostic clinical interview, and clinician and parent-report measures of tic severity, depressive symptoms, anxiety symptoms, behavioral problems, family accommodation and impairment. An exploratory factor analysis of the TFAS showed a two-factor structure, with good internal consistency for the Total score, Modification of Child Environment and Modification of Parent Environment subscales (α = 0.88, 0.86, and 0.81, respectively). Family accommodation was not associated with tic severity. Family accommodation was associated with increased anxiety and depressive symptoms, higher externalizing, rule breaking, aggressive behaviors and social problems, and with greater tic-related functional impairment. Anxiety and externalizing problems (but not depressive symptoms) predicted family accommodation when controlling for tic severity. Family accommodation predicted high levels of functional impairment over and above the effect of tic severity, anxiety, depression and externalizing problems. Family accommodation is a common phenomenon for youth with tic disorders, with modifications typically encompassing changes to the child and/or parent environments. Accommodation was not associated with tic severity, but was related to higher levels of anxiety, depressive symptoms, externalizing symptoms, aggression, and rule breaking behaviors. Results suggest that other emotional symptoms are more likely to drive accommodation practices than the tic symptoms per se.

[Breast cancer metastasis in distal phalanx of the big toe. Case report].

PubMed

Carlesimo, B; Tempesta, M; Fioramonti, P; Bistoni, G; Ruggiero, M; Marchetti, F

2009-01-01

Breast cancer represents the most prevalent malignancies in women and bone is the first site of metastasis in 26-50% of cases. Usually metastasis involve limbs in 16%. We present a rare case of 47-year-old woman, who underwent to monolateral mastectomy for lobular cancer. After 8 years from surgery, she presented pain, swelling and functional limitations, gradually increasing, to the left big toe. X-rays and MRI showed a lucent area of bone destruction on the shaft of the distal phalanx of the left big toe. Surgical biopsy on the excised bone assessed for breast cancer metastasis.

Free toe pulp transfer for digital reconstruction after high-pressure injection injury.

PubMed

Chan, B K; Tham, S K; Leung, M

1999-10-01

We report two cases of high-pressure injection injuries to the fingertip in which free toe pulp flaps were used to resurface the palmar surface of the finger following extensive wound debridement. There was good return of sensibility and, because of the high durability of the donor skin, both patients regained good functional use of the injured digits and returned to heavy manual work. There was minimal associated morbidity of the donor sites. The free toe pulp flap represents an excellent alternative for resurfacing the digit with a large residual skin defect after high-pressure injection injury.

Agility, gnosis, and graphaesthesia for the toes and fingers in children: normative data (ages 7-14 years).

PubMed

Richards, P M; Persinger, M A

2004-01-01

The differential representation of the toes/feet and fingers/hands along the medial and lateral surfaces of the cerebral cortices, respectively, may have diagnostic utility. Normative data for errors for toe and finger graphaesthesia and gnosis, as well as foot and finger agility, were collected for 86 children (ages 7 to 14). The fingers were more agile than the feet, and the right side of the body was more agile than the left side, regardless of age. A marked improvement in toe gnosis, but not in finger gnosis occurred in children after 11-12 years of age. A statistically significant interaction between laterality and gender was due to the greater numbers of errors for both toe and finger gnosis, displayed by girls for the left sides of their bodies compared to their right sides. This discrepancy was not significant for boys.

Clinical and electrophysiological aspects of tics in children.

PubMed

Safiullina, G I; Safiullina, A A

2015-01-01

Tics are diverse in nature inappropriate movements or vocalizations. They significantly degrade patients' quality of life, lead to social difficulties, and disturbance of learning especially during exacerbations. The prevalence of tics among children ranges from 4% to 24%, thus emphasizing the relevance of the problem. To study clinical and electrophysiological features of tics in children with development of new treatment methods. We conducted a comprehensive clinical and electrophysiological examination of 50 patients with tics, aged 5 to 15 years. The control group consisted of 20 healthy children. The research included a thorough study of the history, neurological examination, manual testing of skeletal muscles, psychological testing. Electrophysiological examination included a review of the functional state of corticospinal tract (CST) by the method of magnetic stimulation (MS), study of polysynaptic reflex excitability (PRE) according to a late component of the blink reflex (BR). Statistical analysis included parametric and nonparametric methods of data processing. All children of the study group showed signs of minimal brain dysfunction (MBD), they had complicated antenatal and postnatal history (trauma, disease, occurring with intoxication). There was a trend towards the increase of MBD signs with worsening of tics. Manual diagnosis in patients identified functional blockade at different levels of the vertebral column, sacroiliac joints, we identified latent myofascial trigger points (MFTP) mainly in the cervical-collar zone, in the area of the paravertebral muscles, periosteal triggers in the area of the sacroiliac joints.The research allowed determining decrease in propagation velocity of excitation (PVE) throughout CST in patients with tics. Correlation analysis revealed a negative correlation between the severity of tics and PVE (r = -0.38; p < 0.001).When studying polysynaptic reflex excitability (PRE) a significant predominance of hyper-excited types

Peer Victimization in Youth with Tourette Syndrome and Other Chronic Tic Disorders

ERIC Educational Resources Information Center

Zinner, Samuel H.; Conelea, Christine A.; Glew, Gwen M.; Woods, Douglas W.; Budman, Cathy L.

2012-01-01

Chronic tic disorders including Tourette syndrome have negative impact across multiple functional domains. We explored associations between peer victimization status and tic subtypes, premonitory urges, internalizing symptoms, explosive outbursts, and quality of life among youth with chronic tic disorders, as part of the internet-based omnibus…

Effects of Knee Alignments and Toe Clip on Frontal Plane Knee Biomechanics in Cycling.

PubMed

Shen, Guangping; Zhang, Songning; Bennett, Hunter J; Martin, James C; Crouter, Scott E; Fitzhugh, Eugene C

2018-06-01

Effects of knee alignment on the internal knee abduction moment (KAM) in walking have been widely studied. The KAM is closely associated with the development of medial knee osteoarthritis. Despite the importance of knee alignment, no studies have explored its effects on knee frontal plane biomechanics during stationary cycling. The purpose of this study was to examine the effects of knee alignment and use of a toe clip on the knee frontal plane biomechanics during stationary cycling. A total of 32 participants (11 varus, 11 neutral, and 10 valgus alignment) performed five trials in each of six cycling conditions: pedaling at 80 rpm and 0.5 kg (40 Watts), 1.0 kg (78 Watts), and 1.5 kg (117 Watts) with and without a toe clip. A motion analysis system and a customized instrumented pedal were used to collect 3D kinematic and kinetic data. A 3 × 2 × 3 (group × toe clip × workload) mixed design ANOVA was used for statistical analysis (p < 0.05). There were two different knee frontal plane loading patterns, internal abduction and adduction moment, which were affected by knee alignment type. The knee adduction angle was 12.2° greater in the varus group compared to the valgus group (p = 0.001), yet no difference was found for KAM among groups. Wearing a toe clip increased the knee adduction angle by 0.95º (p = 0.005). The findings of this study indicate that stationary cycling may be a safe exercise prescription for people with knee malalignments. In addition, using a toe clip may not have any negative effects on knee joints during stationary cycling.

Evolutionary, Molecular and Genetic Analyses of Tic22 Homologues in Arabidopsis thaliana Chloroplasts

PubMed Central

Kasmati, Ali Reza; Patel, Ramesh; Ling, Qihua; Karim, Sazzad; Aronsson, Henrik; Jarvis, Paul

2013-01-01

The Tic22 protein was previously identified in pea as a putative component of the chloroplast protein import apparatus. It is a peripheral protein of the inner envelope membrane, residing in the intermembrane space. In Arabidopsis, there are two Tic22 homologues, termed atTic22-III and atTic22-IV, both of which are predicted to localize in chloroplasts. These two proteins defined clades that are conserved in all land plants, which appear to have evolved at a similar rates since their separation >400 million years ago, suggesting functional conservation. The atTIC22-IV gene was expressed several-fold more highly than atTIC22-III, but the genes exhibited similar expression profiles and were expressed throughout development. Knockout mutants lacking atTic22-IV were visibly normal, whereas those lacking atTic22-III exhibited moderate chlorosis. Double mutants lacking both isoforms were more strongly chlorotic, particularly during early development, but were viable and fertile. Double-mutant chloroplasts were small and under-developed relative to those in wild type, and displayed inefficient import of precursor proteins. The data indicate that the two Tic22 isoforms act redundantly in chloroplast protein import, and that their function is non-essential but nonetheless required for normal chloroplast biogenesis, particularly during early plant development. PMID:23675512

5. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, LOOKING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, LOOKING SOUTHWEST - High Mountain Dams in Upalco Unit, Kidney Lake Dam, Ashley National Forest, 4.7 miles North of Miners Gulch Campground, Mountain Home, Duchesne County, UT

6. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, LOOKING ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, LOOKING SOUTHWEST - High Mountain Dams in Upalco Unit, Kidney Lake Dam, Ashley National Forest, 4.7 miles North of Miners Gulch Campground, Mountain Home, Duchesne County, UT

5. DETAIL VIEW OF TOE SPILLWAY SECTION OF LOWWATER DAM, ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

5. DETAIL VIEW OF TOE SPILLWAY SECTION OF LOW-WATER DAM, LOOKING NORTHWEST (UPSTREAM). ST. LOUIS WATER DEPARTMENT INTAKE IN BACKGROUND - Upper Mississippi River 9-Foot Channel Project, Lock & Dam 27, Granite City, Madison County, IL

[Variable magnetic fields in the treatment of tics disorders - preliminary results].

PubMed

Pasek, Jarosław; Jędrzejewska, Anna; Jagodziński, Leszek; Obuchowicz, Anna; Flak, Maria; Sieroń, Aleksander

Tics disorders is frequent pathological syndrome, particularly typical for children's age. The symptoms of this disease are differential, and their intensification individualized, which makes difficult unique recognition. Tics disorders concern the most often the muscles of face, head, upper limbs and trunk. The study group consisted of 16 patients (11 boys and 5 girls) with tics complex disorders about unknown etiology particularly relating of face and upper limbs muscles. In the treatment were the interventions with use a magnetotherapy and magnetostimulation applied. The procedures were ones daily by 3 weeks in two series executed. It author's pool was the frequency of occurrence tics disorders as well as the proportional opinion of effectiveness conducted treatment estimated. After 10 weeks in 14 patients was the decrease of occurrence frequency involuntary movements observed, in proportional scale about 75%. The results of subjective opinion of mood showed, that decrease the frequency tics disorders had in all children the direct shift on improvement their mood, and also satisfaction in their parents. The use of variable magnetic fields influenced on decrease the occurrence frequency tics disorders, and also on improvement quality of life the treated patients.

[Variable magnetic fields in the treatment of tics disorders - preliminary results].

PubMed

Pasek, Jarosław; Jędrzejewska, Anna; Jagodziński, Leszek; Obuchowicz, Anna; Flak, Maria; Sieroń, Aleksander

2016-01-01

Tics disorders is frequent pathological syndrome, particularly typical for children's age. The symptoms of this disease are differential, and their intensification individualized, which makes difficult unique recognition. Tics disorders concern the most often the muscles of face, head, upper limbs and trunk. The study group consisted of 16 patients (11 boys and 5 girls) with tics complex disorders about unknown etiology particularly relating of face and upper limbs muscles. In the treatment were the interventions with use a magnetotherapy and magnetostimulation applied. The procedures were ones daily by 3 weeks in two series executed. It author's pool was the frequency of occurrence tics disorders as well as the proportional opinion of effectiveness conducted treatment estimated. After 10 weeks in 14 patients was the decrease of occurrence frequency involuntary movements observed, in proportional scale about 75%. The results of subjective opinion of mood showed, that decrease the frequency tics disorders had in all children the direct shift on improvement their mood, and also satisfaction in their parents. The use of variable magnetic fields influenced on decrease the occurrence frequency tics disorders, and also on improvement quality of life the treated patients.

Thermodynamic and mechanical properties of TiC from ab initio calculation

DOE Office of Scientific and Technical Information (OSTI.GOV)

Dang, D. Y.; Fan, J. L.; Gong, H. R., E-mail: gonghr@csu.edu.cn

2014-07-21

The temperature-dependent thermodynamic and mechanical properties of TiC are systematically investigated by means of a combination of density-functional theory, quasi-harmonic approximation, and thermal electronic excitation. It is found that the quasi-harmonic Debye model should be pertinent to reflect thermodynamic properties of TiC, and the elastic properties of TiC decease almost linearly with the increase of temperature. Calculations also reveal that TiC possesses a pronounced directional pseudogap across the Fermi level, mainly due to the strong hybridization of Ti 3d and C 2p states. Moreover, the strong covalent bonding of TiC would be enhanced (reduced) with the decrease (increase) of temperature,more » while the change of volume (temperature) should have negligible effect on density of states at the Fermi level. The calculated results agree well with experimental observations in the literature.« less

Quality of life and toxicity in breast cancer patients using adjuvant TAC (docetaxel, doxorubicin, cyclophosphamide), in comparison with FAC (doxorubicin, cyclophosphamide, 5-fluorouracil).

PubMed

Hatam, N; Ahmadloo, N; Ahmad Kia Daliri, A; Bastani, P; Askarian, M

2011-07-01

The aim of this study was to compare two regimens of chemotherapy in patients with breast cancer, including FAC (doxorubicin, cyclophosphamide, and 5-fluorouracil) and TAC (docetaxel, doxorubicin and cyclophosphamide); and analyze the toxicity of these treatments and observe patient's health-related quality of life. Health-related quality of life was assessed for up to 4 months (from the beginning to the end of chemotherapy cycles), using European organization and cancer treatment quality of life questionnaire (EORTC) QLQ-C30. A group of 100 patients, with node-positive breast cancer were studied in order to compare the toxicity of adjuvant therapy TAC with FAC and the subsequent effects on the patient's quality of life. After a 4-month follow-up of patients, our findings showed that despite having the same mean score of QOL at the start of adjuvant chemotherapy, the QOL in TAC arm was decreased more as a result of the higher range of toxicity in TAC regimen. In spite of increase in disease-free patients who received TAC regimen and increase their survival rate, there is significant toxicity and decrease in QOL in TAC protocol compare to FAC protocol. Using prophylactic granulocyte colony stimulating factor (G-CSF) along with increased education aimed at improving patient's knowledge and also the provision of a supportive group involving psychiatrics and patients that have successfully experienced the same treatment may be helpful.

The Neural Circuits that Generate Tics in Gilles de la Tourette Syndrome

PubMed Central

Wang, Zhishun; Maia, Tiago V.; Marsh, Rachel; Colibazzi, Tiziano; Gerber, Andrew; Peterson, Bradley S.

2014-01-01

Objective To study neural activity and connectivity within cortico-striato-thalamo-cortical circuits and to reveal circuit-based neural mechanisms that govern tic generation in Tourette syndrome. Method We acquired fMRI data from 13 participants with Tourette syndrome and 21 controls during spontaneous or simulated tics. We used independent component analysis with hierarchical partner matching to isolate neural activity within functionally distinct regions of cortico-striato-thalamo-cortical circuits. We used Granger causality to investigate causal interactions among these regions. Results We found that the Tourette group exhibited stronger neural activity and interregional causality than controls throughout all portions of the motor pathway including sensorimotor cortex, putamen, pallidum, and substania nigra. Activity in these areas correlated positively with the severity of tic symptoms. Activity within the Tourette group was stronger during spontaneous tics than during voluntary tics in somatosensory and posterior parietal cortices, putamen, and amygdala/hippocampus complex, suggesting that activity in these regions may represent features of the premonitory urges that generate spontaneous tic behaviors. In contrast, activity was weaker in the Tourette group than in controls within portions of cortico-striato-thalamo-cortical circuits that exert top-down control over motor pathways (caudate and anterior cingulate cortex), and progressively less activity in these regions accompanied more severe tic symptoms, suggesting that faulty activity in these circuits may fail to control tic behaviors or the premonitory urges that generate them. Conclusions Our findings taken together suggest that tics are caused by the combined effects of excessive activity in motor pathways and reduced activation in control portions of cortico-striato-thalamo-cortical circuits. PMID:21955933

Reduced Tic Symptomatology in Tourette Syndrome After an Acute Bout of Exercise: An Observational Study.

PubMed

Nixon, Elena; Glazebrook, Cris; Hollis, Chris; Jackson, Georgina M

2014-03-01

In light of descriptive accounts of attenuating effects of physical activity on tics, we used an experimental design to assess the impact of an acute bout of aerobic exercise on tic expression in young people (N = 18) with Tourette Syndrome (TS). We compared video-based tic frequency estimates obtained during an exercise session with tic rates obtained during pre-exercise (baseline) and post-exercise interview-based sessions. Results showed significantly reduced tic rates during the exercise session compared with baseline, suggesting that acute exercise has an attenuating effect on tics. Tic rates also remained reduced relative to baseline during the post-exercise session, likely reflecting a sustained effect of exercise on tic reduction. Parallel to the observed tic attenuation, exercise also had a beneficial impact on self-reported anxiety and mood levels. The present findings provide novel empirical evidence for the beneficial effect of exercise on TS symptomatology bearing important research and clinical implications. © The Author(s) 2014.

The DEP domain-containing protein TOE-2 promotes apoptosis in the Q lineage of C. elegans through two distinct mechanisms

PubMed Central

Gurling, Mark; Talavera, Karla; Garriga, Gian

2014-01-01

Neuroblast divisions in the nematode Caenorhabditis elegans often give rise to a larger neuron and a smaller cell that dies. We have previously identified genes that, when mutated, result in neuroblast divisions that generate daughter cells that are more equivalent in size. This effect correlates with the survival of daughter cells that would normally die. We now describe a role for the DEP domain-containing protein TOE-2 in promoting the apoptotic fate in the Q lineage. TOE-2 localized at the plasma membrane and accumulated in the cleavage furrow of the Q.a and Q.p neuroblasts, suggesting that TOE-2 might position the cleavage furrow asymmetrically to generate daughter cells of different sizes. This appears to be the case for Q.a divisions where loss of TOE-2 led to a more symmetric division and to survival of the smaller Q.a daughter. Localization of TOE-2 to the membrane is required for this asymmetry, but, surprisingly, the DEP domain is dispensable. By contrast, loss of TOE-2 led to loss of the apoptotic fate in the smaller Q.p daughter but did not affect the size asymmetry of the Q.p daughters. This function of TOE-2 required the DEP domain but not localization to the membrane. We propose that TOE-2 ensures an apoptotic fate for the small Q.a daughter by promoting asymmetry in the daughter cell sizes of the Q.a neuroblast division but by a mechanism that is independent of cell size in the Q.p division. PMID:24961802

Association of Tic Disorders and Enterovirus Infection: A Nationwide Population-Based Study.

PubMed

Tsai, Ching-Shu; Yang, Yao-Hsu; Huang, Kuo-You; Lee, Yena; McIntyre, Roger S; Chen, Vincent Chin-Hung

2016-04-01

There has been growing interest in the association between infectious disease and mental disorders, but an association between enterovirus (EV) infection and tic disorders has not been sufficiently explored. Herein, we aim to investigate the association between EV infection and incidence of tic disorders in a nationwide population-based sample using Taiwan's National Health Insurance Research Database. We identified individuals aged ≤18 years prior to 2005 with an inpatient diagnosis of EV infection and/or history of EV infection. Tic disorder was operationalized using International Classification of Disease, Revision 9, Clinical Modification (ICD-9-CM) codes 307.20-307.23. A total of 47,998 individuals with history of EV infection were compared to 47,998 sex-, age-, and urbanization-matched controls on incidence of tic disorders. The mean ± standard deviation follow-up period for all subjects was 9.7 ± 3.6 years; the mean latency period between initial EV infection and incident diagnosis of tic disorder diagnosis was 5.4 ± 2.8 years. EV infection was significantly associated with greater incidence of tic disorders (hazard ratio [HR] = 1.24, 95% CI: 1.07-1.45). When subgrouped on the basis of central nervous system (CNS) involvement, EV infection with CNS involvement was not significantly associated with greater incidence of tic disorders when compared to controls (HR = 1.25, 95% CI: 0.64-2.43); EV infection without CNS involvement was significantly associated greater incidence of tic disorders when compared to controls (HR = 1.24, 95% CI: 1.07-1.45). In addition, hospitalization for an EV infection did not increase the hazard for greater incidence of tic disorders (HR = 1.32, 95% CI: 1.04-1.67 with hospitalization and 1.22, 95% CI: 1.04-1.44 without hospitalization). EV infection is temporally associated with incidence of tic disorders. Our observations add to the growing body of literature implicating immune-inflammatory system in

Early onset obsessive-compulsive disorder with and without tics.

PubMed

de Mathis, Maria Alice; Diniz, Juliana B; Shavitt, Roseli G; Torres, Albina R; Ferrão, Ygor A; Fossaluza, Victor; Pereira, Carlos; Miguel, Eurípedes; do Rosario, Maria Conceicão

2009-07-01

Research suggests that obsessive-compulsive disorder (OCD) is not a unitary entity, but rather a highly heterogeneous condition, with complex and variable clinical manifestations. The aims of this study were to compare clinical and demographic characteristics of OCD patients with early and late age of onset of obsessive-compulsive symptoms (OCS); and to compare the same features in early onset OCD with and without tics. The independent impact of age at onset and presence of tics on comorbidity patterns was investigated. Three hundred and thirty consecutive outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for OCD were evaluated: 160 patients belonged to the "early onset" group (EOG): before 11 years of age, 75 patients had an "intermediate onset" (IOG), and 95 patients were from the "late onset" group (LOG): after 18 years of age. From the 160 EOG, 60 had comorbidity with tic disorders. The diagnostic instruments used were: the Yale-Brown Obsessive Compulsive Scale and the Dimensional Yale-Brown Obsessive Compulsive Scale (DY-BOCS), Yale Global Tics Severity Scale, and Structured Clinical Interview for DSM-IV Axis I Disorders-patient edition. Statistical tests used were: Mann-Whitney, full Bayesian significance test, and logistic regression. The EOG had a predominance of males, higher frequency of family history of OCS, higher mean scores on the "aggression/violence" and "miscellaneous" dimensions, and higher mean global DY-BOCS scores. Patients with EOG without tic disorders presented higher mean global DY-BOCS scores and higher mean scores in the "contamination/cleaning" dimension. The current results disentangle some of the clinical overlap between early onset OCD with and without tics.

Dual optimization method of radiofrequency and quasistatic field simulations for reduction of eddy currents generated on 7T radiofrequency coil shielding.

PubMed

Zhao, Yujuan; Zhao, Tiejun; Raval, Shailesh B; Krishnamurthy, Narayanan; Zheng, Hai; Harris, Chad T; Handler, William B; Chronik, Blaine A; Ibrahim, Tamer S

2015-11-01

To optimize the design of radiofrequency (RF) shielding of transmit coils at 7T and reduce eddy currents generated on the RF shielding when imaging with rapid gradient waveforms. One set of a four-element, 2 × 2 Tic-Tac-Toe head coil structure was selected and constructed to study eddy currents on the RF coil shielding. The generated eddy currents were quantitatively studied in the time and frequency domains. The RF characteristics were studied using the finite difference time domain method. Five different kinds of RF shielding were tested on a 7T MRI scanner with phantoms and in vivo human subjects. The eddy current simulation method was verified by the measurement results. Eddy currents induced by solid/intact and simple-structured slotted RF shielding significantly distorted the gradient fields. Echo-planar images, B1+ maps, and S matrix measurements verified that the proposed slot pattern suppressed the eddy currents while maintaining the RF characteristics of the transmit coil. The presented dual-optimization method could be used to design RF shielding and reduce the gradient field-induced eddy currents while maintaining the RF characteristics of the transmit coil. © 2014 Wiley Periodicals, Inc.

Tourette syndrome and other chronic tic disorders: an update on clinical management.

PubMed

Martino, Davide; Pringsheim, Tamara M

2018-02-01

The management of Tourette syndrome (TS) and other chronic tic disorders occurs in multiple stages and begins with comprehensive assessment and complex psychoeducation. Behavioral and pharmacological interventions (second stage) are needed when tics cause physical or psychosocial impairment. Deep brain stimulation surgery or experimental therapies represent the third stage. Areas covered: Discussed are recent advances in assessment and therapy of chronic tic disorders, encompassing the three stages of intervention, with the addition of experimental, non-invasive brain stimulation strategies. A PubMed search was performed using as keywords: 'tic disorders', 'Tourette syndrome', 'assessment', 'rating scales', 'behavioral treatment', 'pharmacological treatment', 'deep brain stimulation', 'transcranial magnetic (or current) stimulation', and 'transcranial current stimulation'. More than 300 peer-reviewed articles were evaluated. The studies discussed have been selected on the basis of novelty and impact. Expert commentary: Comprehensive assessment of tic disorders and psychoeducation are crucial to a correct active management approach. Behavioral treatments represent first line of active interventions, with increasing potential offered by telehealth. Antipsychotics and alpha agonists remain first line pharmacological interventions for tics, although VMAT-2 inhibitors appear promising. Deep brain stimulation is a potential option for medically refractory, severely disabled patients with tics, but age and target selection require further investigation.

The influence of different food and drink on tics in Tourette syndrome.

PubMed

Müller-Vahl, Kirsten R; Buddensiek, Nadine; Geomelas, Menedimos; Emrich, Hinderk M

2008-04-01

Tourette syndrome (TS) is characterized by waxing and waning motor and vocal tics. Because standard medication often remains unsatisfactory, many patients seek alternative medicine. The aim of this study was to increase experience about the influence of food and drinks in TS. A standardized questionnaire was sent to 887 people recruited from our Tourette outpatient clinic and the German TS self-aid group. Respondents should assess whether 32 different foods influenced their tics. Two hundred twenty-four questionnaires could be used for analyses. A significant positive correlation (tic deterioration) was found for caffeine- and theine-containing drinks such as coke (p<0.001), coffee (p<0.001) and black tea (p<0.001) as well as for preserving agents (p<0.001), refined sugar (p<0.001) and sweeteners (p<0.001). A significant negative correlation (tic improvement) was not found. Results from this first survey investigating the influence of special foods and drinks on tics demonstrated that 34% and 47% of responders, respectively, assessed that coffee and coke deteriorate tics. It, therefore, can be speculated that caffeine may further stimulate an already overactive dopaminergic system in TS and thus increases tics. However, from these preliminary data, no further general recommendations regarding special diets and food restrictions can be made.

Cross-Disorder Genetic Analysis of Tic Disorders, Obsessive-Compulsive, and Hoarding Symptoms.

PubMed

Zilhão, Nuno R; Smit, Dirk J; Boomsma, Dorret I; Cath, Danielle C

2016-01-01

Hoarding, obsessive-compulsive disorder (OCD), and Tourette's disorder (TD) are psychiatric disorders that share symptom overlap, which might partly be the result of shared genetic variation. Population-based twin studies have found significant genetic correlations between hoarding and OCD symptoms, with genetic correlations varying between 0.1 and 0.45. For tic disorders, studies examining these correlations are lacking. Other lines of research, including clinical samples and GWAS or CNV data to explore genetic relationships between tic disorders and OCD, have only found very modest if any shared genetic variation. Our aim was to extend current knowledge on the genetic structure underlying hoarding, OC symptoms (OCS), and lifetime tic symptoms and, in a trivariate analysis, assess the degree of common and unique genetic factors contributing to the etiology of these disorders. Data have been gathered from participants in the Netherlands Twin Register comprising a total of 5293 individuals from a sample of adult monozygotic (n = 2460) and dizygotic (n = 2833) twin pairs (mean age 33.61 years). The data on Hoarding, OCS, and tic symptoms were simultaneously analyzed in Mplus. A liability threshold model was fitted to the twin data, analyzing heritability of phenotypes and of their comorbidity. Following the criteria for a probable clinical diagnosis in all phenotypes, 6.8% of participants had a diagnosis of probable hoarding disorder (HD), 6.3% of OCS, and 12.8% of any probable lifetime tic disorder. Genetic factors explained 50.4, 70.1, and 61.1% of the phenotypic covariance between hoarding-OCS, hoarding-tics, and OCS-tics, respectively. Substantial genetic correlations were observed between hoarding and OCS (0.41), hoarding and tics (0.35), and between OCS and tics (0.37). These results support the contribution of genetic factors in the development of these disorders and their comorbidity. Furthermore, tics were mostly influenced by specific

Effects of Knee Alignments and Toe Clip on Frontal Plane Knee Biomechanics in Cycling

PubMed Central

Shen, Guangping; Zhang, Songning; Bennett, Hunter J.; Martin, James C.; Crouter, Scott E.; Fitzhugh, Eugene C.

2018-01-01

Effects of knee alignment on the internal knee abduction moment (KAM) in walking have been widely studied. The KAM is closely associated with the development of medial knee osteoarthritis. Despite the importance of knee alignment, no studies have explored its effects on knee frontal plane biomechanics during stationary cycling. The purpose of this study was to examine the effects of knee alignment and use of a toe clip on the knee frontal plane biomechanics during stationary cycling. A total of 32 participants (11 varus, 11 neutral, and 10 valgus alignment) performed five trials in each of six cycling conditions: pedaling at 80 rpm and 0.5 kg (40 Watts), 1.0 kg (78 Watts), and 1.5 kg (117 Watts) with and without a toe clip. A motion analysis system and a customized instrumented pedal were used to collect 3D kinematic and kinetic data. A 3 × 2 × 3 (group × toe clip × workload) mixed design ANOVA was used for statistical analysis (p < 0.05). There were two different knee frontal plane loading patterns, internal abduction and adduction moment, which were affected by knee alignment type. The knee adduction angle was 12.2° greater in the varus group compared to the valgus group (p = 0.001), yet no difference was found for KAM among groups. Wearing a toe clip increased the knee adduction angle by 0.95º (p = 0.005). The findings of this study indicate that stationary cycling may be a safe exercise prescription for people with knee malalignments. In addition, using a toe clip may not have any negative effects on knee joints during stationary cycling. Key points Varus or valgus alignment did not cause increased frontal-plane knee joint loading, suggesting stationary cycling is a safe exercise. This study supports that using a toe clip did not lead to abnormal frontal-plane knee loading during stationary cycling. Two different knee frontal plane loading patterns, knee abduction and adduction moment, were observed during stationary cycling, which are likely affected by

Lethocerus americanus, the "toe biter".

PubMed

Huntley, A

1998-10-01

Lethocerus americanus is a large water bug commonly found in ponds and slowly moving fresh water. Also known as the "toe biter" for its encounters with swimmers, it has the reputation of inflicting painful bites when carelessly handled. It normally feeds on other pond life: insects, tadpoles, salamander, small fish, and snails. These large tan or brown bugs may leave their habitat at night in search of mates or another pond. It is thought that the relative nearness of bright lights for a creature that evolved using celestial navigation, results in disorientation, spiral flight paths, and eventual death from exhaustion. This would account for the occasional find of several dead giant water bugs underneath street lamps.

A Cluster Analysis of Tic Symptoms in Children and Adults with Tourette Syndrome: Clinical Correlates and Treatment Outcome

PubMed Central

McGuire, Joseph F.; Nyirabahizi, Epiphanie; Kircanski, Katharina; Piacentini, John; Peterson, Alan L.; Woods, Douglas W.; Wilhelm, Sabine; Walkup, John T.; Scahill, Lawrence

2013-01-01

Cluster analytic methods have examined the symptom presentation of chronic tic disorders (CTDs), with limited agreement across studies. The present study investigated patterns, clinical correlates, and treatment outcome of tic symptoms. 239 youth and adults with CTDs completed a battery of assessments at baseline to determine diagnoses, tic severity, and clinical characteristics. Participants were randomly assigned to receive either a comprehensive behavioral intervention for tics (CBIT) or psychoeducation and supportive therapy (PST). A cluster analysis was conducted on the baseline Yale Global Tic Severity Scale (YGTSS) symptom checklist to identify the constellations of tic symptoms. Four tic clusters were identified: Impulse Control and Complex Phonic Tics; Complex Motor Tics; Simple Head Motor/Vocal Tics; and Primarily Simple Motor Tics. Frequencies of tic symptoms showed few differences across youth and adults. Tic clusters had small associations with clinical characteristics and showed no associations to the presence of coexisting psychiatric conditions. Cluster membership scores did not predict treatment response to CBIT or tic severity reductions. Tic symptoms distinctly cluster with few difference across youth and adults, or coexisting conditions. This study, which is the first to examine tic clusters in relation to treatment, suggested that tic symptom profiles respond equally well to CBIT. PMID:24144615

Tic Related Activity Restriction as a Predictor of Emotional Functioning and Quality of Life

PubMed Central

Conelea, Christine A.; Busch, Andrew M.; Catanzaro, Mark A.; Budman, Cathy L.

2013-01-01

Objectives Tourette Syndrome (TS) is a chronic neuropsychiatric condition that frequently persists into adulthood. Existing research has identified demographic and symptom-level variables associated with psychopathology and poor quality of life in TS. However, behavior patterns associated with enhanced or adaptive psychological and global functioning among adults with TS have yet to be empirically identified. The current study examined whether tic-specific activity restriction is related to emotional functioning and quality of life in adults with TS. Methods Participants were 509 adults from the Tourette Syndrome Impact Survey who completed self-report measures of demographics, tic severity, emotional functioning, quality of life, and tic related general and social activity restriction. Results Partial correlations controlling for tic severity indicated that tic related general and social activity restriction were significantly correlated with lower quality of life and poorer emotional functioning. Hierarchical linear regression models indicated that activity restriction significantly predicted lower quality of life and poorer emotional functioning when controlling for tic severity and demographic variables. Conclusions Adults who restrict fewer activities due to tics, regardless of tic severity, experience greater quality of life and better emotional functioning. Clinically, adults with chronic tics may benefit from interventions focused on enhancing engagement in valued life activities. PMID:24156871

Solid oxide membrane-assisted controllable electrolytic fabrication of metal carbides in molten salt.

PubMed

Zou, Xingli; Zheng, Kai; Lu, Xionggang; Xu, Qian; Zhou, Zhongfu

2016-08-15

Silicon carbide (SiC), titanium carbide (TiC), zirconium carbide (ZrC), and tantalum carbide (TaC) have been electrochemically produced directly from their corresponding stoichiometric metal oxides/carbon (MOx/C) precursors by electrodeoxidation in molten calcium chloride (CaCl2). An assembled yttria stabilized zirconia solid oxide membrane (SOM)-based anode was employed to control the electrodeoxidation process. The SOM-assisted controllable electrochemical process was carried out in molten CaCl2 at 1000 °C with a potential of 3.5 to 4.0 V. The reaction mechanism of the electrochemical production process and the characteristics of these produced metal carbides (MCs) were systematically investigated. X-ray diffraction, scanning electron microscopy, and transmission electron microscopy analyses clearly identify that SiC, TiC, ZrC, and TaC carbides can be facilely fabricated. SiC carbide can be controlled to form a homogeneous nanowire structure, while the morphologies of TiC, ZrC, and TaC carbides exhibit porous nodular structures with micro/nanoscale particles. The complex chemical/electrochemical reaction processes including the compounding, electrodeoxidation, dissolution-electrodeposition, and in situ carbonization processes in molten CaCl2 are also discussed. The present results preliminarily demonstrate that the molten salt-based SOM-assisted electrodeoxidation process has the potential to be used for the facile and controllable electrodeoxidation of MOx/C precursors to micro/nanostructured MCs, which can potentially be used for various applications.

Relationship of serum ferritin level and tic severity in children with Tourette syndrome.

PubMed

Ghosh, Debabrata; Burkman, Elizabeth

2017-08-01

Tics can be considered hyperkinetic movements akin to restless leg syndrome (RLS). Drawing the analogy of iron deficiency as an etiology of RLS, it is conceivable that iron deficiency may underlie or worsen tics in Tourette syndrome (TS). The purpose of this study was to evaluate the relationship between serum ferritin levels and tic severity, as well as consequent impact on life, in children with TS. Children <18 years, diagnosed with TS during 2009-2015, were reviewed. Only those with serum ferritin testing were included. The following data were collected: tic severity, impact on life, medication, comorbidities, blood count, and serum ferritin at diagnosis and follow-up. In fifty-seven patients, M:F = 2:1, serum ferritin was 48.0 ± 33.28 ng/mL, tic severity score 2.3 ± 0.80, impact on life score 2.2 ± 0.93, and composite score 4.57 ± 1.6. Serum ferritin was not influenced by comorbid obsessive compulsive disorder (OCD), attention deficit hyperactive disorder (ADHD), or anxiety (P > 0.16). Thirty-eight percent with low serum ferritin (≤50 ng/mL) (n = 37) had severe tics (>5 composite score), compared with 25% in normal ferritin group (n = 20). Over 6-12 months, tic severity score improved in both iron treated groups, deficient (2.70 to 1.90) and sufficient (2.40 to 1.95), whereas tics worsened or remained the same when not treated with iron. Our data suggest iron deficiency may be associated with more severe tics with higher impact on TS children, independent of the presence of OCD, ADHD, or anxiety. Iron supplementation showed a trend towards improvement of tic severity upon follow-up. We suggest a double-blind, placebo-controlled prospective study to reach a definite conclusion.

A cluster analysis of tic symptoms in children and adults with Tourette syndrome: clinical correlates and treatment outcome.

PubMed

McGuire, Joseph F; Nyirabahizi, Epiphanie; Kircanski, Katharina; Piacentini, John; Peterson, Alan L; Woods, Douglas W; Wilhelm, Sabine; Walkup, John T; Scahill, Lawrence

2013-12-30

Cluster analytic methods have examined the symptom presentation of chronic tic disorders (CTDs), with limited agreement across studies. The present study investigated patterns, clinical correlates, and treatment outcome of tic symptoms. 239 youth and adults with CTDs completed a battery of assessments at baseline to determine diagnoses, tic severity, and clinical characteristics. Participants were randomly assigned to receive either a comprehensive behavioral intervention for tics (CBIT) or psychoeducation and supportive therapy (PST). A cluster analysis was conducted on the baseline Yale Global Tic Severity Scale (YGTSS) symptom checklist to identify the constellations of tic symptoms. Four tic clusters were identified: Impulse Control and Complex Phonic Tics; Complex Motor Tics; Simple Head Motor/Vocal Tics; and Primarily Simple Motor Tics. Frequencies of tic symptoms showed few differences across youth and adults. Tic clusters had small associations with clinical characteristics and showed no associations to the presence of coexisting psychiatric conditions. Cluster membership scores did not predict treatment response to CBIT or tic severity reductions. Tic symptoms distinctly cluster with little difference across youth and adults, or coexisting conditions. This study, which is the first to examine tic clusters and response to treatment, suggested that tic symptom profiles respond equally well to CBIT. Clinical trials.gov. identifiers: NCT00218777; NCT00231985. © 2013 Elsevier Ireland Ltd. All rights reserved.

The Roles of Phasic and Tonic Dopamine in Tic Learning and Expression.

PubMed

Maia, Tiago V; Conceição, Vasco A

2017-09-15

Tourette syndrome (TS) prominently involves dopaminergic disturbances, but the precise nature of those disturbances has remained elusive. A substantial body of empirical work and recent computational models have characterized the specific roles of phasic and tonic dopamine (DA) in action learning and selection, respectively. Using insights from this work and models, we suggest that TS involves increases in both phasic and tonic DA, which produce increased propensities for tic learning and expression, respectively. We review the evidence from reinforcement-learning and habit-learning studies in TS, which supports the idea that TS involves increased phasic DA responses; we also review the evidence that tics engage the habit-learning circuitry. On the basis of these findings, we suggest that tics are exaggerated, maladaptive, and persistent motor habits reinforced by aberrant, increased phasic DA responses. Increased tonic DA amplifies the tendency to execute learned tics and also provides a fertile ground of motor hyperactivity for tic learning. We review evidence suggesting that antipsychotics may counter both the increased propensity for tic expression, by increasing excitability in the indirect pathway, and the increased propensity for tic learning, by shifting plasticity in the indirect pathway toward long-term potentiation (and possibly also through more complex mechanisms). Finally, we review evidence suggesting that low doses of DA agonists that effectively treat TS decrease both phasic and tonic DA, thereby also reducing the propensity for both tic learning and tic expression, respectively. Copyright © 2017 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Human's Capability to Discriminate Spatial Forces at the Big Toe.

PubMed

Hagengruber, Annette; Höppner, Hannes; Vogel, Jörn

2018-01-01

A key factor for reliable object manipulation is the tactile information provided by the skin of our hands. As this sensory information is so essential in our daily life it should also be provided during teleoperation of robotic devices or in the control of myoelectric prostheses. It is well-known that feeding back the tactile information to the user can lead to a more natural and intuitive control of robotic devices. However, in some applications it is difficult to use the hands as natural feedback channels since they may already be overloaded with other tasks or, e.g., in case of hand prostheses not accessible at all. Many alternatives for tactile feedback to the human hand have already been investigated. In particular, one approach shows that humans can integrate uni-directional (normal) force feedback at the toe into their sensorimotor-control loop. Extending this work, we investigate the human's capability to discriminate spatial forces at the bare front side of their toe. A state-of-the-art haptic feedback device was used to apply forces with three different amplitudes-2 N, 5 N, and 8 N-to subjects' right big toes. During the experiments, different force stimuli were presented, i.e., direction of the applied force was changed, such that tangential components occured. In total the four directions up (distal), down (proximal), left (medial), and right (lateral) were tested. The proportion of the tangential force was varied corresponding to a directional change of 5° to 25° with respect to the normal force. Given these force stimuli, the subjects' task was to identify the direction of the force change. We found the amplitude of the force as well as the proportion of tangential forces to have a significant influence on the success rate. Furthermore, the direction right showed a significantly different successrate from all other directions. The stimuli with a force amplitude of 8 N achieved success rates over 89% in all directions. The results of the user study

Human's Capability to Discriminate Spatial Forces at the Big Toe

PubMed Central

Hagengruber, Annette; Höppner, Hannes; Vogel, Jörn

2018-01-01

A key factor for reliable object manipulation is the tactile information provided by the skin of our hands. As this sensory information is so essential in our daily life it should also be provided during teleoperation of robotic devices or in the control of myoelectric prostheses. It is well-known that feeding back the tactile information to the user can lead to a more natural and intuitive control of robotic devices. However, in some applications it is difficult to use the hands as natural feedback channels since they may already be overloaded with other tasks or, e.g., in case of hand prostheses not accessible at all. Many alternatives for tactile feedback to the human hand have already been investigated. In particular, one approach shows that humans can integrate uni-directional (normal) force feedback at the toe into their sensorimotor-control loop. Extending this work, we investigate the human's capability to discriminate spatial forces at the bare front side of their toe. A state-of-the-art haptic feedback device was used to apply forces with three different amplitudes—2 N, 5 N, and 8 N—to subjects' right big toes. During the experiments, different force stimuli were presented, i.e., direction of the applied force was changed, such that tangential components occured. In total the four directions up (distal), down (proximal), left (medial), and right (lateral) were tested. The proportion of the tangential force was varied corresponding to a directional change of 5° to 25° with respect to the normal force. Given these force stimuli, the subjects' task was to identify the direction of the force change. We found the amplitude of the force as well as the proportion of tangential forces to have a significant influence on the success rate. Furthermore, the direction right showed a significantly different successrate from all other directions. The stimuli with a force amplitude of 8 N achieved success rates over 89% in all directions. The results of the user

Tics, Tourette Syndrome, and OCD

MedlinePlus

... AAP Find a Pediatrician Health Issues Conditions Abdominal ADHD Allergies & Asthma Autism Cancer Chest & Lungs Chronic Conditions ... In children who eventually develop tic disorders and ADHD, the ADHD usually develops 2 to 3 years ...

Air swallowing as a tic.

PubMed

Weil, Rimona S; Cavanna, Andrea E; Willoughby, John M T; Robertson, Mary M

2008-11-01

The authors present a patient with Gilles de la Tourette syndrome who developed abdominal distension and bloating due to air swallowing. We suggest that this air swallowing may have been due to a tic.

7. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, WITH ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

7. VIEW SHOWING DOWNSTREAM FACE AND TOE OF DAM, WITH OUTLET CULVERT AND WING RETAINING WALLS, LOOKING NORTH - High Mountain Dams in Upalco Unit, Twin Pots Dam, Ashley National Forest, 10.1 miles North of Mountain Home, Mountain Home, Duchesne County, UT

The preclinical evaluation of TIC10/ONC201 as an anti-pancreatic cancer agent.

PubMed

Zhang, Qiangbo; Wang, Hong; Ran, Lin; Zhang, Zongli; Jiang, Runde

2016-08-05

Here we evaluated the potential anti-pancreatic cancer activity by TIC10/ONC201, a first-in-class small-molecule inducer of tumor necrosis (TNF)-related apoptosis-inducing ligand (TRAIL). The in vitro results showed that TIC10 induced potent cytotoxic and cytostatic activities in several human pancreatic cancer cell lines (Panc-1, Mia-PaCa2, AsPC-1 or L3.6). TIC10 activated both extrinsic (TRAIL-caspase-8-dependent) and endogenous/mitochondrial (caspase-9-dependent) apoptosis pathways in the pancreatic cancer cells. Molecularly, we showed that TIC10 inhibited Akt-Erk activation, yet induced TRAIL expression in pancreatic cancer cells. Significantly, TIC10, at a relatively low concentration, sensitized gemcitabine-induced growth inhibition and apoptosis against pancreatic cancer cells. Further, TIC10 and gemcitabine synergistically inhibited Panc-1 xenograft growth in SCID mice. The combination treatment also significantly improved mice survival. In addition, Akt-Erk in-activation and TRAIL/cleaved-caspase-8 induction were observed in TIC10-treated Panc-1 xenografts. Together, the preclinical results of the study demonstrate the potent anti-pancreatic cancer activity by TIC10, or with gemcitabine. Copyright © 2016 Elsevier Inc. All rights reserved.

Tic40, a membrane-anchored co-chaperone homolog in the chloroplast protein translocon

PubMed Central

Chou, Ming-Lun; Fitzpatrick, Lynda M.; Tu, Shuh-Long; Budziszewski, Gregory; Potter-Lewis, Sharon; Akita, Mitsuru; Levin, Joshua Z.; Keegstra, Kenneth; Li, Hsou-min

2003-01-01

The function of Tic40 during chloroplast protein import was investigated. Tic40 is an inner envelope membrane protein with a large hydrophilic domain located in the stroma. Arabidopsis null mutants of the atTic40 gene were very pale green and grew slowly but were not seedling lethal. Isolated mutant chloroplasts imported precursor proteins at a lower rate than wild-type chloroplasts. Mutant chloroplasts were normal in allowing binding of precursor proteins. However, during subsequent translocation across the inner membrane, fewer precursors were translocated and more precursors were released from the mutant chloroplasts. Cross-linking experiments demonstrated that Tic40 was part of the translocon complex and functioned at the same stage of import as Tic110 and Hsp93, a member of the Hsp100 family of molecular chaperones. Tertiary structure prediction and immunological studies indicated that the C-terminal portion of Tic40 contains a TPR domain followed by a domain with sequence similarity to co-chaperones Sti1p/Hop and Hip. We propose that Tic40 functions as a co-chaperone in the stromal chaperone complex that facilitates protein translocation across the inner membrane. PMID:12805212

Tic-Related Obsessive-Compulsive Disorder (OCD): Phenomenology and Treatment Outcome in the Pediatric OCD Treatment Study II

PubMed Central

Conelea, Christine A.; Walther, Michael R.; Freeman, Jennifer B.; Garcia, Abbe M.; Sapyta, Jeffrey; Khanna, Muniya; Franklin, Martin

2014-01-01

Objective Prior research has shown that youth with co-occurring tic disorders and obsessive-compulsive disorder (OCD) may differ from those with non-tic-related OCD in terms of clinical characteristics and treatment responsiveness. A broad definition of “tic-related” was used to examine whether children with tics in the Pediatric OCD Treatment Study II differed from those without tics in terms of demographic and phenomenological characteristics and acute treatment outcome. Method Participants were 124 youth aged 7-17 years with a primary diagnosis of OCD who were partial responders to an adequate serotonin reuptake inhibitor (SRI) trial. Participants were randomized to medication management, medication management plus instructions in cognitive behavioral therapy (CBT), or medication management plus full CBT. Tic status was based on the presence of motor and/or vocal tics on the Yale Global Tic Severity Scale. Results Tics were identified in 53% of the sample. Those with tic-related OCD did not differ from those with non-tic-related OCD in terms of age, family history of tics, OCD severity, OCD-related impairment, or comorbidity. Those with tics were responded equally in all treatment conditions. Conclusion Tic-related OCD was very prevalent using a broad definition of tic status. Results suggest that youth with this broad definition of tic-related OCD do not have increased OCD severity or inference, higher comorbidity rates or severity, or worsened functioning and support the use of CBT in this population. This highlights the importance of not making broad assumptions about OCD symptoms most likely to occur in an individual with comorbid tics. Clinical trial registration information--Treatment of Pediatric OCD for SRI Partial Responders; http://clinicaltrials.gov/show/; NCT00074815. PMID:25457929

Tic-related obsessive-compulsive disorder (OCD): phenomenology and treatment outcome in the Pediatric OCD Treatment Study II.

PubMed

Conelea, Christine A; Walther, Michael R; Freeman, Jennifer B; Garcia, Abbe M; Sapyta, Jeffrey; Khanna, Muniya; Franklin, Martin

2014-12-01

Prior research has shown that youth with co-occurring tic disorders and obsessive-compulsive disorder (OCD) may differ from those with non-tic-related OCD in terms of clinical characteristics and treatment responsiveness. A broad definition of "tic-related" was used to examine whether children with tics in the Pediatric OCD Treatment Study II differed from those without tics in terms of demographic and phenomenological characteristics and acute treatment outcomes. Participants were 124 youth aged 7 to 17 years, inclusive, with a primary diagnosis of OCD who were partial responders to an adequate serotonin reuptake inhibitor (SRI) trial. Participants were randomized to medication management, medication management plus instructions in cognitive-behavioral therapy (CBT), or medication management plus full CBT. Tic status was based on the presence of motor and/or vocal tics on the Yale Global Tic Severity Scale. Tics were identified in 53% of the sample. Those with tic-related OCD did not differ from those with non-tic-related OCD in terms of age, family history of tics, OCD severity, OCD-related impairment, or comorbidity. Those with tics responded equally in all treatment conditions. Tic-related OCD was very prevalent using a broad definition of tic status. Results suggest that youth with this broad definition of tic-related OCD do not have increased OCD severity or inference, higher comorbidity rates or severity, or worsened functioning, and support the use of CBT in this population. This highlights the importance of not making broad assumptions about OCD symptoms most likely to occur in an individual with comorbid tics. Clinical trial registration information-Treatment of Pediatric OCD for SRI Partial Responders; http://clinicaltrials.gov; NCT00074815. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Mindfulness-based stress reduction for Tourette Syndrome and Chronic Tic Disorder: a pilot study.

PubMed

Reese, Hannah E; Vallejo, Zayda; Rasmussen, Jessica; Crowe, Katherine; Rosenfield, Elizabeth; Wilhelm, Sabine

2015-03-01

In this pilot study we sought to develop and test a modified form of mindfulness-based stress reduction (MBSR-tics) for the treatment of Tourette Syndrome (TS) and Chronic Tic Disorder (CTD). Our specific aims were: 1) To determine the feasibility and acceptability of an 8-week trial of MBSR-tics in individuals 16 and older with TS or CTD and 2) To determine the efficacy of an 8-week trial of MBSR-tics in individuals 16 and older with TS or CTD. Eighteen individuals age 16-67 completed an uncontrolled open trial of MBSR-tics. The intervention consisted of 8 weekly 2-hour classes and one 4hour retreat in the fifth or sixth week of the program. Symptomatic assessments were performed at baseline, post-treatment, and one-month follow-up. MBSR-tics proved to be a feasible and acceptable intervention. It resulted in significant improvement in tic severity and tic-related impairment. 58.8% of subjects were deemed treatment responders. Therapeutic gains were maintained at 1-month follow-up. Improvements in tic severity were correlated with increases in self-reported levels of mindfulness. This small open pilot study provides preliminary support for the feasibility, acceptability, and efficacy of MBSR-tics for individuals 16 or older with TS or CTD. A larger randomized controlled trial with blind assessment is necessary to confirm these initial, promising findings. Trial Registration Partners Clinical Trials Registry Number 2011P000606 (clinicaltrials.partners.org). Copyright © 2014 Elsevier Inc. All rights reserved.

Global dysrhythmia of cerebro-basal ganglia-cerebellar networks underlies motor tics following striatal disinhibition.

PubMed

McCairn, Kevin W; Iriki, Atsushi; Isoda, Masaki

2013-01-09

Motor tics, a cardinal symptom of Tourette syndrome (TS), are hypothesized to arise from abnormalities within cerebro-basal ganglia circuits. Yet noninvasive neuroimaging of TS has previously identified robust activation in the cerebellum. To date, electrophysiological properties of cerebellar activation and its role in basal ganglia-mediated tic expression remain unknown. We performed multisite, multielectrode recordings of single-unit activity and local field potentials from the cerebellum, basal ganglia, and primary motor cortex using a pharmacologic monkey model of motor tics/TS. Following microinjections of bicuculline into the sensorimotor putamen, periodic tics occurred predominantly in the orofacial region, and a sizable number of cerebellar neurons showed phasic changes in activity associated with tic episodes. Specifically, 64% of the recorded cerebellar cortex neurons exhibited increases in activity, and 85% of the dentate nucleus neurons displayed excitatory, inhibitory, or multiphasic responses. Critically, abnormal discharges of cerebellar cortex neurons and excitatory-type dentate neurons mostly preceded behavioral tic onset, indicating their central origins. Latencies of pathological activity in the cerebellum and primary motor cortex substantially overlapped, suggesting that aberrant signals may be traveling along divergent pathways to these structures from the basal ganglia. Furthermore, the occurrence of tic movement was most closely associated with local field potential spikes in the cerebellum and primary motor cortex, implying that these structures may function as a gate to release overt tic movements. These findings indicate that tic-generating networks in basal ganglia mediated tic disorders extend beyond classical cerebro-basal ganglia circuits, leading to global network dysrhythmia including cerebellar circuits.

A Primary Role for Nucleus Accumbens and Related Limbic Network in Vocal Tics.

PubMed

McCairn, Kevin W; Nagai, Yuji; Hori, Yukiko; Ninomiya, Taihei; Kikuchi, Erika; Lee, Ju-Young; Suhara, Tetsuya; Iriki, Atsushi; Minamimoto, Takafumi; Takada, Masahiko; Isoda, Masaki; Matsumoto, Masayuki

2016-01-20

Inappropriate vocal expressions, e.g., vocal tics in Tourette syndrome, severely impact quality of life. Neural mechanisms underlying vocal tics remain unexplored because no established animal model representing the condition exists. We report that unilateral disinhibition of the nucleus accumbens (NAc) generates vocal tics in monkeys. Whole-brain PET imaging identified prominent, bilateral limbic cortico-subcortical activation. Local field potentials (LFPs) developed abnormal spikes in the NAc and the anterior cingulate cortex (ACC). Vocalization could occur without obvious LFP spikes, however, when phase-phase coupling of alpha oscillations were accentuated between the NAc, ACC, and the primary motor cortex. These findings contrasted with myoclonic motor tics induced by disinhibition of the dorsolateral putamen, where PET activity was confined to the ipsilateral sensorimotor system and LFP spikes always preceded motor tics. We propose that vocal tics emerge as a consequence of dysrhythmic alpha coupling between critical nodes in the limbic and motor networks. VIDEO ABSTRACT. Copyright © 2016 Elsevier Inc. All rights reserved.

[Chronic tics and Tourette syndrome in children and adolescents: diagnostic and treatment characteristics].

PubMed

Zavadenko, N N; Doronina, O B; Nesterovsky, Yu E

2015-01-01

Chronic tics (CT) are observed in 3-4% population, Tourette syndrome (TS) in 0.1-3.0%. In most cases, tic disorders start at age 2-15 years, but frequently they are diagnosed late. Clinical presentations of tics and comorbid disorders are various and depend on child's age. Difficulties in treatment of CT are associated with their persistence and those for TS with the fluctuating course of tics and probable onset of the disease in the form of behavioral disorders. Treatment of CT and TS is individual. Methods of behavioral and psychotherapy are recommended for a certain period of time if tics do not hamper everyday life. Increase in tick frequency and severity indicate the necessity of using pharmacological treatment. The European recommendations on pharmacotherapy of tic disorders and the drugs available in Russia are considered. Results of the studies on the efficacy of antiepileptic drugs and tenoten children in CT and TS are presented.

Meta-Analysis: Risk of Tics Associated With Psychostimulant Use in Randomized, Placebo-Controlled Trials.

PubMed

Cohen, Stephanie C; Mulqueen, Jilian M; Ferracioli-Oda, Eduardo; Stuckelman, Zachary D; Coughlin, Catherine G; Leckman, James F; Bloch, Michael H

2015-09-01

Clinical practice currently restricts the use of psychostimulant medications in children with tics or a family history of tics for fear that tics will develop or worsen as a side effect of treatment. Our goal was to conduct a meta-analysis to examine the risk of new onset or worsening of tics as an adverse event of psychostimulants in randomized, placebo-controlled trials. We conducted a PubMed search to identify all double-blind, randomized, placebo-controlled trials examining the efficacy of psychostimulant medications in the treatment of children with attention-deficit/hyperactivity disorder (ADHD). We used a fixed effects meta-analysis with risk ratio of new onset or worsening tics in children treated with psychostimulants compared to placebo. We used stratified subgroup analysis and meta-regression to examine the effects of stimulant type, dose, duration of treatment, recorder of side effect data, trial design, and mean age of participants on the measured risk of tics. We identified 22 studies involving 2,385 children with ADHD for inclusion in our meta-analysis. New onset tics or worsening of tic symptoms were commonly reported in the psychostimulant (event rate = 5.7%, 95% CI = 3.7%-8.6%) and placebo groups (event rate = 6.5%, 95% CI = 4.4%-9.5%). The risk of new onset or worsening of tics associated with psychostimulant treatment was similar to that observed with placebo (risk ratio = 0.99, 95% CI = 0.78-1.27, z = -0.05, p = .962). Type of psychostimulant, dose, duration of treatment, recorder, and participant age did not affect risk of new onset or worsening of tics. Crossover studies were associated with a significantly greater measured risk of tics with psychostimulant use compared to parallel group trials. Meta-analysis of controlled trials does not support an association between new onset or worsening of tics and psychostimulant use. Clinicians may want to consider rechallenging children who report new onset or worsening of tics with psychostimulant

Color of the tarsi and toes of the black rail

USGS Publications Warehouse

Meanley, B.; Stewart, R.E.

1960-01-01

Examination of two fresh specimens of the Black Rail (Laterallus jamaicensis) has prompted us to call attention to the color of the tarsi and toes of this species, since our observations do not agree with published accounts. Audubon (Ornithological Biography, vol. IV; 361, 1838) and Friedmann (Birds of North and Middle America, U.S. Nat'l. Mus. Bull., 50: 154, 1941) state that the tarsi and toes are bright yellowish-green. Descriptions in other publications are similar. Prominent bird artists, including Fuertes, have depicted the color of these appendages as yellowish-green, yellow, or green; while Allan Brooks' illustration of this species (The Book of Birds, vol. I, National Geographic Society, p. 291, 1932) shows pink legs. An adult female specimen was collected by J. A. Hagar, C. S. Robbins, and R. E. Stewart near Elliott Island, Maryland, on 8 June 1958. A second adult Black Rail, presumed to be a female by its dull color and call, was caught alive by the authors in the same area on 17 June 1958, and is still held in captivity. The tarsi and toes of these two birds show no trace of yellow or green. They appear grayish, matching "Flint" (plate 56-1C) or "Gunmetal" (plate 48-2C) in Maerz and Paul's "A Dictionary of Color" (1930), and "blackish-brown" in the color charts provided with Palmer and Reilly's "A Concise Color Standard" (Am. Ornith. Union Handbook Fund, 1956). A grayed-off blackish-brown would seem to be an appropriate description.

Tactical Applications (TacApps) User Design Workshop, Analysis and Findings Report

DTIC Science & Technology

2017-11-01

discarded. By returning to this activity, the TacApps design team was able to compare each participants “gut reaction” to their more nuanced answer...UNCLASSIFIED UNCLASSIFIED AD-E403 957 Technical Report ARWSE-CR-16004 TACTICAL APPLICATIONS (TACAPPS) USER DESIGN WORKSHOP...author(s) and should not be construed as an official Department of the Army position, policy, or decision, unless so designated by other

Study on Microstructures and Properties of Porous TiC Ceramics Fabricated by Powder Metallurgy

NASA Astrophysics Data System (ADS)

Ma, Yana; Bao, Chonggao; Han, Longhao; Chen, Jie

2017-02-01

Powder metallurgy process was used to fabricate porous titanium carbide (TiC) ceramics, in which TiC powders were taken as the raw materials, nickel was used as the metallic binder and urea was the space-holder. Microstructure, composition and phase of porous TiC ceramics were characterized by scanning electron microscopy (SEM) and x-ray diffraction (XRD). Flexure strength of the porous TiC ceramics was tested by a three-point bending method. The results show that macropores and micropores coexist in the prepared porous TiC ceramics. Moreover, the pore number, size and distribution in porous TiC ceramics can be controlled on demand. Particularly, the factors such as the number or size of space-holder, compacting pressure and Ni content have significant effect on the porosity and flexure strength.

A Unique Case of Classic Kaposi's sarcoma restricted to the toes.

PubMed

Renteria, Anne S; Marshall, Vickie A; Sun, Yanyu; Chockalingam, Porselvi; Cooper, Jay S; Huang, Yiwu; Whitby, Denise

2013-01-01

Kaposi's sarcoma associated-herpesvirus causes all forms of Kaposi's sarcoma, and six major subtypes have been described based on the amino acid sequences of the open reading frame K1. A 71-year-old man from China, HIV negative, presented with nodules on the dorsal aspect of his toes. Biopsy confirmed the diagnosis of Kaposi's sarcoma and virology studies of his blood and saliva confirmed the presence of Kaposi's sarcoma associated-herpesvirus infection. Viral genotyping was consistent with subtype C3. Intervention has been deferred as our patient has remained clinically asymptomatic and without evident growth of his lesions over a 2-year follow up. We herein report the first known case of Kaposi's sarcoma restricted to the toes caused by the viral subtype C3 in an HIV-negative patient from Harbin, China.

Intensive outpatient comprehensive behavioral intervention for tics: A case series

PubMed Central

Blount, Tabatha H; Lockhart, Ann-Louise T; Garcia, Rocio V; Raj, Jeslina J; Peterson, Alan L

2014-01-01

Recent randomized clinical trials have established the efficacy of Comprehensive Behavioral Intervention for Tics (CBIT) in treating children and adults with Tourette syndrome and persistent tic disorders. However, the standard CBIT protocol uses a weekly outpatient treatment format (i.e., 8 sessions over 10 wk), which may be inconvenient or impractical for some patients, particularly patients, who are required to travel long distances in order to receive care. In contrast, an intensive outpatient program may increase accessibility to evidence-based behavioral treatments for Tourette syndrome and other persistent tic disorders by eliminating the necessity of repeated travel. This case series evaluated the use of an intensive outpatient program CBIT (IOP CBIT) for the treatment of 2 preadolescent males (ages 10 and 14 years) with Tourette syndrome. The IOP CBIT treatment protocol included several hours of daily treatment over a 4-d period. Both children evidenced notable reductions in their tics and maintained treatment gains at follow-up. Moreover, both patients and their parents expressed treatment satisfaction with the IOP CBIT format. This case series addresses an important research gap in the behavioral treatment of tic disorders literature. The patients’ treatment outcomes indicate that IOP CBIT is a promising treatment that warrants more systematic investigation. PMID:25325069

Tic-reducing effects of music in patients with Tourette's syndrome: Self-reported and objective analysis.

PubMed

Bodeck, Sabine; Lappe, Claudia; Evers, Stefan

2015-05-15

Self-reports by musicians affected with Tourette's syndrome and other sources of anecdotal evidence suggest that tics stop when subjects are involved in musical activity. For the first time, we studied this effect systematically using a questionnaire design to investigate the subjectively assessed impact of musical activity on tic frequency (study 1) and an experimental design to confirm these results (study 2). A questionnaire was sent to 29 patients assessing whether listening to music and musical performance would lead to a tic frequency reduction or increase. Then, a within-subject repeated measures design was conducted with eight patients. Five experimental conditions were tested: baseline, musical performance, short time period after musical performance, listening to music and music imagery. Tics were counted based on videotapes. Analysis of the self-reports (study 1) yielded in a significant tic reduction both by listening to music and musical performance. In study 2, musical performance, listening to music and mental imagery of musical performance reduced tic frequency significantly. We found the largest reduction in the condition of musical performance, when tics almost completely stopped. Furthermore, we could find a short-term tic decreasing effect after musical performance. Self-report assessment revealed that active and passive participation in musical activity can significantly reduce tic frequency. Experimental testing confirmed patients' perception. Active and passive participation in musical activity reduces tic frequency including a short-term lasting tic decreasing effect. Fine motor control, focused attention and goal directed behavior are believed to be relevant factors for this observation. Copyright © 2015 Elsevier B.V. All rights reserved.

How Much Do We Know about Adult-onset Primary Tics? Prevalence, Epidemiology, and Clinical Features.

PubMed

Robakis, Daphne

2017-01-01

Tic disorders are generally considered to be of pediatric onset; however, reports of adult-onset tics exist in the literature. Tics can be categorized as either primary or secondary, with the latter being the larger group in adults. Primary or idiopathic tics that arise in adulthood make up a subset of tic disorders whose epidemiologic and clinical features have not been well delineated. Articles to be included in this review were identified by searching PubMed, SCOPUS, and Web of Science using the terms adult- and late-onset tics, which resulted in 120 unique articles. Duplicates were removed. Citing references were identified using Google Scholar; all references were reviewed for relevance. The epidemiologic characteristics, clinical phenomenology, and optimal treatment of adult-onset tics have not been ascertained. Twenty-six patients with adult-onset, primary tics were identified from prior case reports. The frequency of psychiatric comorbidities may be lower in adults than in children, and obsessive compulsive disorder was the most common comorbidity. Adult-onset primary tics tend to wax and wane, occur predominantly in males, are often both motor and phonic in the same individual, and are characterized by a poor response to treatment. We know little about adult-onset tic disorders, particularly ones without a secondary association or cause. They are not common, and from the limited data available, appear to share some but not all features with childhood tics. Further research will be important in gaining a better understanding of the epidemiology and clinical manifestations of this disorder.

How Much Do We Know about Adult-onset Primary Tics? Prevalence, Epidemiology, and Clinical Features

PubMed Central

Robakis, Daphne

2017-01-01

Background Tic disorders are generally considered to be of pediatric onset; however, reports of adult-onset tics exist in the literature. Tics can be categorized as either primary or secondary, with the latter being the larger group in adults. Primary or idiopathic tics that arise in adulthood make up a subset of tic disorders whose epidemiologic and clinical features have not been well delineated. Methods Articles to be included in this review were identified by searching PubMed, SCOPUS, and Web of Science using the terms adult- and late-onset tics, which resulted in 120 unique articles. Duplicates were removed. Citing references were identified using Google Scholar; all references were reviewed for relevance. Results The epidemiologic characteristics, clinical phenomenology, and optimal treatment of adult-onset tics have not been ascertained. Twenty-six patients with adult-onset, primary tics were identified from prior case reports. The frequency of psychiatric comorbidities may be lower in adults than in children, and obsessive compulsive disorder was the most common comorbidity. Adult-onset primary tics tend to wax and wane, occur predominantly in males, are often both motor and phonic in the same individual, and are characterized by a poor response to treatment. Discussion We know little about adult-onset tic disorders, particularly ones without a secondary association or cause. They are not common, and from the limited data available, appear to share some but not all features with childhood tics. Further research will be important in gaining a better understanding of the epidemiology and clinical manifestations of this disorder. PMID:28546883

Marginal Bidding: An Application of the Equimarginal Principle to Bidding in TAC SCM

NASA Astrophysics Data System (ADS)

Greenwald, Amy; Naroditskiy, Victor; Odean, Tyler; Ramirez, Mauricio; Sodomka, Eric; Zimmerman, Joe; Cutler, Clark

We present a fast and effective bidding strategy for the Trading Agent Competition in Supply Chain Management (TAC SCM). In TAC SCM, manufacturers compete to procure computer parts from suppliers (the procurement problem), and then sell assembled computers to customers in reverse auctions (the bidding problem). This paper is concerned only with bidding, in which an agent must decide how many computers to sell and at what prices to sell them. We propose a greedy solution, Marginal Bidding, inspired by the Equimarginal Principle, which states that revenue is maximized among possible uses of a resource when the return on the last unit of the resource is the same across all areas of use. We show experimentally that certain variations of Marginal Bidding can compute bids faster than our ILP solution, which enables Marginal Bidders to consider future demand as well as current demand, and hence achieve greater revenues when knowledge of the future is valuable.

The premonitory urge to tic: measurement, characteristics, and correlates in older adolescents and adults.

PubMed

Reese, Hannah E; Scahill, Lawrence; Peterson, Alan L; Crowe, Katherine; Woods, Douglas W; Piacentini, John; Walkup, John T; Wilhelm, Sabine

2014-03-01

In addition to motor and/or vocal tics, many individuals with Tourette syndrome (TS) or chronic tic disorder (CTD) report frequent, uncomfortable sensory phenomena that immediately precede the tics. To date, examination of these premonitory sensations or urges has been limited by inconsistent assessment tools. In this paper, we examine the psychometric properties of a nine-item self-report measure, the Premonitory Urge to Tic Scale (PUTS) and examine the characteristics and correlates of the premonitory urge to tic in a clinical sample of 122 older adolescents and adults with TS or CTD. The PUTS demonstrated adequate internal consistency, temporal stability, and concurrent validity. Premonitory urges were endorsed by the majority of individuals. Most individuals reported some relief from the urges after completing a tic and being able to stop their tics even if only temporarily. Degree of premonitory urges was not significantly correlated with age, and we did not observe any gender differences. Degree of premonitory urges was significantly correlated with estimated IQ and tic severity, but not severity of comorbid obsessive-compulsive disorder or attention-deficit hyperactivity disorder. Also, it was not related to concomitant medication status. These findings represent another step forward in our understanding of the premonitory sensations associated with TS and CTD. © 2013.

Subjective versus objective measures of tic severity in Tourette syndrome - The influence of environment.

PubMed

Barnea, Meirav; Benaroya-Milshtein, Noa; Gilboa-Sechtman, Eva; Woods, Douglas W; Piacentini, John; Fennig, Silvana; Apter, Alan; Steinberg, Tamar

2016-08-30

The objective of this study was to examine the influence of environmental challenges on tic expression by subjective and objective measures. The study group consisted of 41 children aged 6-18 years (M=10.15, SD=2.73) with a primary diagnosis of Tourette syndrome. Subjective measures included the Functional Assessment Interview developed for this study and three standard validated instruments. The objective measure was a video-recording of the patients in five daily-life situations: watching television, doing homework, being alone, receiving attention when ticcing, and talking to a stranger. In addition, the effect of premonitory urges on assessment of tic expression was evaluated. The associations between the subjective and objective measures of tic expression were moderate to low. A significantly higher number of tics were observed in the television situation, and a significantly lower number in the alone situation, compared to the other situations. Higher levels of premonitory urge were associated with greater awareness of objectively measured tic expression. In conclusion, tic expression is significantly influenced by the environment. Subjective measures of tic expression may be misleading. These results have implications for refining the clinical assessment of tics, improving research methodology, and developing new therapeutic strategies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Adult-onset tic disorder, motor stereotypies, and behavioural disturbance associated with antibasal ganglia antibodies.

PubMed

Edwards, Mark J; Dale, Russell C; Church, Andrew J; Trikouli, Eleni; Quinn, Niall P; Lees, Andrew J; Giovannoni, Gavin; Bhatia, Kailash P

2004-10-01

The onset of tics in adulthood is rare and, unlike the childhood variety, there is commonly a secondary environmental cause. We present four cases (1 man, 3 women) with an adult onset tic disorder (mean age of onset, 36 years; range, 27-42 years) associated with the presence of serum antibasal ganglia antibodies (ABGA). One patient had motor tics and unusual motor stereotypies, 2 had multiple motor and vocal tics, and the remaining patient had motor tics only. Concomitant psychiatric disturbance was noted in 3 cases. In 2 cases, there was a close temporal relationship between upper respiratory tract infection and the subsequent onset of tics. Imaging was possible in three cases and was normal in two but revealed a lesion involving the right caudate and lentiform nuclei in the other. We suggest that there might be a causal relationship between ABGA and the clinical syndrome in these cases and that ABGA should be considered as a possible etiology for adult-onset tics. (c) 2004 Movement Disorder Society.

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 30 Mineral Resources 1 2012-07-01 2012-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 30 Mineral Resources 1 2014-07-01 2014-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 30 Mineral Resources 1 2013-07-01 2013-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

30 CFR 57.11005 - Fixed ladder anchorage and toe clearance.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 1 2011-07-01 2011-07-01 false Fixed ladder anchorage and toe clearance. 57.11005 Section 57.11005 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR... MINES Travelways and Escapeways Travelways-Surface and Underground § 57.11005 Fixed ladder anchorage and...

Prevalence of Tics Among 6- to 12-Year-Old Schoolchildren in the Itagui Municipality, Colombia, in 2010.

PubMed

Giraldo, Blair Ortiz; David, María; Sánchez, Yaneth; Miranda, Johanna; Sierra, Javier Mauricio; Cornejo, José William

2013-11-01

Tics are the most frequent movement disorder in children and they are most prevalent during the school-age years. Most tics are transitory; however, certain tics can be chronic, causing negative repercussions at school, within the family, and socially. In some cases, tics are associated with obsessive compulsive disorder, attention-deficit hyperactivity disorder (ADHD) and other conditions that require diagnosis and prompt treatment. In South America, there are no indexed studies determining the prevalence of tics in school-age children. The aim of this study was to establish the prevalence of tics in schoolchildren aged 6 to 12 years. From 16 000 students aged 6 to 12 years who were enrolled in first to fifth grade, a sample of 346 school-aged children was chosen via a multistage sampling process that randomized the educational systems in terms of proportional size and the stratification between public and private schools and adjusted for the design effect. The students were screened and those who were positive for tics underwent clinical evaluations and semistructured interviews by the researchers to determine the prevalence of the disease. The parents and teachers of 323 students returned our surveys (93.3%). One hundred thirty-eight students (42.7%) were considered positive for tics based on parents' and teachers' reports. The clinical evaluation established a 17.97% prevalence of tics (58 students), and 25 students (43.2%) also met diagnostic criteria for ADHD. Of the students with tics, 27.6% presented with transitory tics, and 72.4% presented with chronic tics. Gilles de la Tourette syndrome was detected in 11 of the children (3.4%). The average age of child with tics was 9 ± 1.5 years, and the majority of the children with tics attended third grade at a basic primary school. Children from public and private schools were equally likely to present with tics. Tics are noteworthy in our field and are associated with other neurobehavioral disorders, such as

Botulinum toxin type A in simple motor tics: short-term and long-term treatment-effects.

PubMed

Rath, Judith J G; Tavy, Dénes L J; Wertenbroek, Agnes A A C M; van Woerkom, Theodoor C A M; de Bruijn, Sebastiaan F T M