Northwestern Medical Faculty Foundation

Neuronal coding and decoding would be compromised if neuronal responses were highly variable. Intriguingly, neuronal spike counts (SCs) show a reduction in across-trial variance ( ) in response to sensory stimulation, when SC variance is normalized by SC mean, that is, when using the Fano factor 1. Inspired by this seminal finding, has also been studied in electroencephalography (EEG) signals, revealing effects of various stimulus and cognitive factors as well as disease states. Here, we empirically show that outside of evoked potentials, the of the EEG or local field potential (LFP) is very highly correlated to the intra-trial variance ( ), which corresponds to the well-known power metric. We propose that the LFP power, rather than the raw LFP signal, should be considered with regard to putative changes of its variability. We quantify LFP power variability as the standard deviation of the logarithm of the power ratio between an active and a baseline condition, normalized by the mean of that log(power ratio), that is the coefficient of variation (CV) of the log(power ratio). This CV(log(power ratio)) is reduced for gamma and alpha power when they are enhanced by stimulation, and it is enhanced for alpha power when it is reduced by stimulation. This suggests a potential inverse relation between changes in band-limited power and the corresponding CV. We propose that the CV(log(power ratio)) is a useful metric that can be computed for numerous existing and future LFP, EEG or MEG datasets, which will provide insights into those signals' frequency-specific variability and how they might be used for neuronal coding and decoding.

Pseudomonas aeruginosa is a gram-negative bacterium frequently implicated in recalcitrant sinonasal infections, especially in immunocompromised hosts. We report 6 cases of rapidly progressive pseudomonal acute rhinosinusitis producing tissue necrosis and, in certain cases, cranial nerve palsies. Retrospective review of 6 patients with aggressive necrotizing sinonasal infections treated at 4 tertiary academic medical centers with sinonasal cultures growing P. aeruginosa in the absence of other pathology. A total of 6 patients were identified. In all cases, there was tissue necrosis that appeared to mimic an invasive process such as mucormycosis, prompting urgent surgical intervention. Pathologic analysis revealed fibropurulent exudates in backgrounds of positive P. aeruginosa cultures without evidence of invasive fungal organisms or malignancy. Four of the 6 patients presented with cranial nerve palsies, with 3 patients having vision changes and 3 complaining of trigeminal neuropathy. Four of 6 patients improved clinically over time after surgery and antibiotic therapy; 1 remains in follow-up without complete improvement and 1 has succumbed to other causes. P. aeruginosa is a tenacious organism that is frequently associated with severe, recalcitrant sinonasal infections. We report the first case series of necrotizing sinonasal infections caused by this organism, and illustrate that, in rare cases, P. aeruginosa may mimic and behave like life-threatening conditions such as fulminant invasive fungal sinusitis or malignancy.

Many breast cancer survivors feel constrained in discussing their cancer experience with others. Limited evidence suggests that social constraints (e.g., avoidance and criticism) from loved ones may negatively impact breast cancer survivors' global health, but research has yet to examine relationships between social constraints and common physical symptoms. Informed by social cognitive processing theory, this study examined whether perceived social constraints from partners and healthcare providers (HCPs) were associated with fatigue, sleep disturbance, and attentional functioning among long-term breast cancer survivors (N = 1052). In addition, avoidant coping and self-efficacy for symptom management were examined as potential mediators of these relationships. Long-term breast cancer survivors (mean years since diagnosis = 6) completed questionnaires assessing social constraints from partners and HCPs, avoidant coping, self-efficacy for symptom management, and symptoms (i.e., fatigue, sleep disturbance, and attentional functioning). Structural equation modeling was used to evaluate the hypothesized relationships among variables in two models: one focused on social constraints from partners and one focused on social constraints from HCPs. Both models demonstrated good fit. Consistent with theory and prior research, greater social constraints from both partners and HCPs were associated with greater symptom burden (i.e., greater fatigue and sleep disturbance, poorer attentional functioning). In addition, all relationships were mediated by avoidant coping and self-efficacy for symptom management. Findings are consistent with social cognitive processing theory and suggest that symptom management interventions may be enhanced by addressing the impact of social constraints from survivors' partners and HCPs on their coping and self-efficacy. Copyright © 2016 John Wiley & Sons, Ltd.

The present study examined the cognitive, physical and psychological characteristics associated with elder self-neglect in a USA Chinese older population. The Population Study of Chinese Elderly in Chicago is a population-based epidemiological study of Chinese older adults in the greater Chicago area. In total, 3159 Chinese older adults aged 60 years and older were interviewed from 2011 to 2013. Personal and home environment was rated on hoarding, personal hygiene, house in need of repair, unsanitary conditions and inadequate utility. The prevalence of elder self-neglect of all severities was higher among older adults who were with worsening health status, lower cognitive function, lower physical function and more depressive symptoms. Poorer health status (mild self-neglect OR 1.20, 95% CI 1.06-1.35; moderate/severe self-neglect: OR 1.52, 95% CI 1.30-1.77), lower physical function (activities of daily living moderate/severe self-neglect OR 1.09, 95% CI 1.05-1.13; instrumental activities of daily living mild OR 1.04, 95% CI 1.03-1.06; instrumental activities of dailiy living moderate/severe OR 1.06, 95% CI 1.04-1.07), lower cognitive function (mild self-neglect OR 1.05, 95% CI 1.03-1.07; moderate/severe self-neglect OR 1.07, 95% CI 1.04-1.09) and more depressive symptoms (mild self-neglect OR 1.05, 95% CI 1.02-1.07; moderate/severe self-neglect OR 1.08, 95% CI 1.06-1.11) were significantly associated with increased risk for elder self-neglect of all severities. Older adults with lower levels of cognitive, physical, and psychological health were more likely to report elder self-neglect and its phenotypes. Future research is required to examine risk/protective factors associated with elder self-neglect. Geriatr Gerontol Int 2016; 16: 1051-1062.